title: Modified Collis-Nissen procedure for long gap pure esophageal atresia.
abstract: OBJECTIVE
  Esophageal reconstruction in long gap esophageal atresia (EA) is technically challenging, and several procedures have been described. The purpose of this study is to review our experience with the modified Collis-Nissen procedure in the repair of long gap pure EA.
  
  
  METHODS
  Six patients with pure EA were treated at our institution from 1985 to 2008. Patients' demographics, surgical technique, timing of repair, early and late complications, and long-term functional outcomes were retrospectively reviewed.
  
  
  RESULTS
  Five primary cases and 1 redo case were included. The mean gap length was 5.3 vertebral bodies (range, 4-6). Modified Collis-Nissen procedure was performed at a mean age of 11.6 months (range, 9-14 months) in primary cases. There was 1 anastomotic leak in the redo case, which healed spontaneously. Two patients had anastomotic strictures requiring balloon dilatations. Patients were weaned from tube feeding at a mean duration of 4 months (range, 1-6 months) postoperatively. All patients have normal oral intake at the last follow-up visit. Two adult patients had normal growth and development and no digestive symptoms. Endoscopic examination and pH monitoring showed no signs of significant gastroesophageal reflux.
  
  
  CONCLUSIONS
  Modified Collis-Nissen procedure is a good option to consider in patients with long gap pure EA and is associated with an acceptable complication rate and promising short- and long-term results.
authors.affiliation: Department of Pediatric Surgery, National Hospital Okayama Medical Center, Okayama 701-1192, Japan. nakahara1108@yahoo.co.jp
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nakahara
authors.forename: Koji
authors.initials: K
authors.lastname: Aoyama
authors.forename: Takafumi
authors.initials: T
authors.lastname: Goto
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Iwamura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Asai
mesh_terms: D000328:Adult; D004933:Esophageal Atresia / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome