title: Caustic esophageal strictures in children: 30 years' experience.
abstract: Many children in developing countries continue to sustain caustic esophageal injures. The first line of treatment is dilatation, unless contraindicated, where 60% to 80% success rate is expected. In cases of failure, esophageal replacement is the only hope for achieving normal swallowing. Over the last 30 years, more than 850 cases of esophageal replacement were done in the Pediatric Surgery Department at Ain-Shams University. Three types of replacement were performed, gastric pull-up (75 cases), retrosternal colon replacement (550 cases), and, in the last 12 years, transhiatal esophagectomy with posterior mediastinal colon replacement (225 cases). Complications in the last 475 cases include 10% cervical leakage, 5% proximal strictures, 2% postoperative intestinal obstruction, 1% mortality, and 0.6% late graft stenosis. Colonic replacement of the esophagus is the ideal treatment in cases of caustic esophageal strictures after failure of dilatation. The posterior mediastinal route is shorter, and in long-term follow-up results show improved evacuation and less reflux than with the retrosternal route.
authors.affiliation: Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Alaa F
authors.initials: AF
authors.lastname: Hamza
authors.forename: Sameh
authors.initials: S
authors.lastname: Abdelhay
authors.forename: Hatem
authors.initials: H
authors.lastname: Sherif
authors.forename: Tarek
authors.initials: T
authors.lastname: Hasan
authors.forename: Hisham
authors.initials: H
authors.lastname: Soliman
authors.forename: Ashraf
authors.initials: A
authors.lastname: Kabesh
authors.forename: Ibraheem
authors.initials: I
authors.lastname: Bassiouny
authors.forename: Ahmed F
authors.initials: AF
authors.lastname: Bahnassy
mesh_terms: D000143:Acids / Q000506:poisoning*; D000293:Adolescent; D000468:Alkalies / Q000506:poisoning*; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000637:transplantation; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000628:therapy*; D004947:Esophagus / Q000637:transplantation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016042:Transplantation, Heterotopic
chemical_list: D000143:Acids; D000468:Alkalies