title: Laparoscopically assisted transhiatal esophagectomy with esophagogastroplasty for post-corrosive esophageal stricture treatment in children.
abstract: A tight post-corrosive esophageal stricture in a child poses significant surgical challenges. Many studies have described minimally invasive esophagectomy in adults, but very few reports have described this technique in children. Minimally invasive esophagectomy represents a new alternative to conventional open esophagectomy. This retrospective study evaluated the safety and efficacy of laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment. Twenty-seven children with post-corrosive esophageal stricture were subjected to this technique. Their ages ranged from 3 to 13.5 years (mean 5.6 years). Fourteen were females and thirteen were males. None of the procedures needed to be converted to an open approach, and there were neither intra-operative complications nor increased blood loss. Left-sided pneumothorax occurred in one case only (3.7%). The mean operating time was 160 min (range 120-180). Three patients were admitted postoperatively to intensive care unit for a period of 48 h for assisted ventilation. Mean hospital stay was 4 days (range 3-7 days). Anastomotic leakage occurred in three patients (11.1%), while anastomotic stricture occurred in four patients (14.8%). About 93.5% of our cases have achieved excellent results. Post-operative nutritional status was satisfactory and accepted. Laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment in children is safe, visible, effective, and an accepted operative technique. The cosmetic result is excellent.
authors.affiliation: Pediatric Surgical Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. rafikshalaby@hotmail.com
authors.forename: Rafik
authors.initials: R
authors.lastname: Shalaby
authors.forename: Abdelmonaem
authors.initials: A
authors.lastname: Shams
authors.forename: Soliman Mohamed
authors.initials: SM
authors.lastname: Soliman
authors.forename: Abelhady
authors.initials: A
authors.lastname: Samaha
authors.forename: Hossam Abdelrazek
authors.initials: HA
authors.lastname: Ibrahim
mesh_terms: D000293:Adolescent; D002057:Burns, Chemical / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome