ESOPHAGEAL REPLACEMENT WITH COLON IN CHILDREN USING EITHER THE INTRATHORACIC OR RETROSTERNAL ROUTE - AN ANALYSIS OF BOTH SURGICAL AND LONG-TERM RESULTS

A total of 28 colon esophageal replacements performed in children for long gap esophageal atresia (22 patients), and intractable caustic str icture (6 patients) were reviewed, Emphasis was placed on identifying the pros and cons of the different reconstruction techniques: intratho racic route (ITR) (19 patients) and retrosternal route (RSR) (9 patien ts), No hospital mortality occurred, whereas a higher morbidity rate o ccurred among patients operated on using the ITR as opposed to the RSR (68% vs 55%; P not significant). Six patients developed an anastomoti c fistula (21% with the ITR vs 22% with the RSR; P not significant), w hereas an anastomotic stenosis occurred in 13 patients (67% with the R SR, and 37% with the ITR; P < 0.07), Overall, dysphagia was the most p revalent symptom at 3 months follow-up, but had significantly decrease d at the final follow-up (54% vs 16%; P < 0.0027), Functional results improved significantly during the follow-up (score 1-2 vs score 3-4; F isher test: P = 0.001), However, despite the higher morbidity rate, be tter functional results were achieved using the ITR as opposed to the RSR.