Lateral esophagostomy: an alternative in the initial management of long gap esophageal atresia without fistula.
The authors report an alternative method of cervical esophagostomy that was used in a child with type A esophageal atresia. This method involved performing a lateral esophagostomy in the proximal pouch, preserving its distal end, allowing the child to swallow normally, without choking, while stimulating the spontaneous growth of the proximal esophagus. As a result, the infant could be discharged home on G-tube feedings while waiting for spontaneous growth of the proximal pouch to occur. There were no episodes of aspiration during this period, and definitive reconstruction through end-to-end esophageal anastomosis was accomplished successfully at the age of 18 months. The authors consider that this alternative might increase the possibility of a definitive correction through delayed primary anastomosis of the infant's own esophagus in children with this type of malformation.
Aloisi
A S
AS
Division of Pediatric Surgery, Santa Casa de Piracicaba, University of Campinas School of Medical Sciences, Campinas, Brazil.
de Freitas
S
S
Colombo
A C
AC
Amalfi
R
R
Sbragia-Neto
L
L
Bustorff-Silva
J M
JM
D000714:Anastomosis, Surgical; D002404:Catheterization; D004750:Enteral Nutrition; D004933:Esophageal Atresia / Q000000981:diagnostic imaging / Q000601:surgery*; D004946:Esophagostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011859:Radiography