title: [Gastric tube esophagoplasty using the retroesternal route in children].
abstract: BACKGROUND
  Esophageal replacement is a surgical alternative once native esophagus can't be preserved. Different organs and routes for the replacement have been described, being the retroesternal route the least used. The aim is to present our results using gastric tube esophagoplasty with a retroesternal approach.
  
  
  METHODS
  We performed a retrospective and descriptive study of 11 patients operated from 2000 to 2015. Median age at surgery was 2.2 years (5 months-9 years) and median weight was 11.2 kg (7.8-21). A gastric tube esophagoplasty using the retroesternal route, forced pyloric dilatation and end-to-side esophago-gastric cervical anastomosis were performed.
  
  
  RESULTS
  Ten esophagus replacements had long-gap esophageal atresia and one, severe esophagus caustication secondary to button battery ingestion. No intraoperatory complications were observed. Three patients developed anastomosis leak. Two cases developed anastomotic stenosis managed with endoscopic dilatation in 2 and 4 occasions, respectively. Four patients showed occasional dumping syndrome and are asymptomatic after medical treatment. With a median follow up of 6.3 years (0.2-14.8), all our patients are alive and complete oral diet has been established in all of them.
  
  
  CONCLUSIONS
  Gastric tube esophagoplasty using the retroesternal route is a suitable technique in order to reestablish gastrointestinal continuity once native esophagus can't be preserved. In our experience is a safe option, related to few complications.
authors.affiliation: Cirugía Neonatal y Fetal. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: L
authors.initials: L
authors.lastname: García Martínez
authors.affiliation: Cirugía Neonatal y Fetal. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J A
authors.initials: JA
authors.lastname: Molino Gahete
authors.affiliation: Gastroenterología Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: S
authors.initials: S
authors.lastname: Redecillas Ferreiro
authors.affiliation: Cirugía Neonatal y Fetal. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: E
authors.initials: E
authors.lastname: Bordón Cabrera
authors.affiliation: Cirugía Digestiva Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Bueno Recio
authors.affiliation: Cirugía Neonatal y Fetal. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: G
authors.initials: G
authors.lastname: Guillén Burrieza
authors.affiliation: Cirugía Digestiva Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: C
authors.initials: C
authors.lastname: Giné Prades
authors.affiliation: Cirugía Digestiva Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Lara Valtueña
authors.affiliation: Cirugía Neonatal y Fetal. Hospital Universitario Vall d'Hebron. Barcelona.
authors.forename: J
authors.initials: J
authors.lastname: Lloret Roca
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004106:Dilatation; D004750:Enteral Nutrition / Q000295:instrumentation*; D004944:Esophagoplasty / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013270:Stomach / Q000601:surgery*
keywords: Esophageal replacement; Gastric pull-up; Gastric tube esophagoplasty; Long-gap esophageal atresia