Outcomes of esophagoplasty in children (a 14-year experience)

Introduction. The authors analyze the effectiveness of one-stage esophageal plasty in children. They consider -from different points of view- possible problems accompanying such surgical interventions as well as complications and high mortality.Material and methods. The article summarizes outcomes after esophagoplasty in 61 patient who were at the surgical department of the Center for Pediatrics and Pediatric Surgery (Almaty, Kazakhstan) during 2006–2020 (June). Among them there were 24 (38%) children after the first stage of cervical esophagostomy combined with gastrostomy in esophageal atresia; 34 (56%) children had decompensated post-burn esophageal stricture and after ineffective conservative treatment; 1 (2%) patient had esophageal varicose veins because of the portal hypertension syndrome with formed cicatricial esophageal stricture and with high risk for bougienage; 2 (4%) patients had an extended peptic stricture of the esophagus as a complication of gastroesophageal reflux disease (Barrett esophagus).Results. One-stage coloesophagoplasty was performed in 44 (72%) children. Gastroesophagoplasty with the whole stomach transposition was performed in 12 (20%) children with esophageal atresia; in 3 (5%) - replacement for post-burn cicatricial stenosis and in 1 (2%) - because of varicose veins in the esophagus.Conclusion. The choice of esophagoplasty technique should be individualized depending on patient’s general state, on pathological lesions in the esophagus as well as on previous surgeries on the abdominal organs, if any.