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Original Research

RMJ. 2012; 37(2): 165-167


Our experience of gastric pull up in long gap esophageal atresia

Nadeem Akhtar, Mansoor Mahmood, Shazia Yousaf, Amjad Mahmood, Saqib Ismail, Israr Zahir, Sheema Luqman, Abdul Hameed Khan.

Abstract
Objective: The aim of the study was to assess the outcome after esophageal replacement using gastric pull-up performed in children with esophageal atresia (EA) and tracheoesophageal fistula.
Study Design: Retrospective study.
Setting and Duration: Department of pediatric surgery, the children’s hospital, Pakistan institute of medical sciences (PIMS), Islamabad from January 2008 to June 2011.

Materials and Methods: During January 2008 to June 2011, gastric pull-up was performed in ten patients with isolated esophageal atresia. All patients initially underwent cervical esophagostomy and feeding gastrostomy. The cervical esophagus was mobilized through the neck, the stomach was mobilized through laparotomy, and pylromyotomy was done in all patients. The stomach was brought into neck via Trans hital route. A single layer esophageo-gastric anastomosis was done in the neck in all patients.
Results: The total patients were ten with male to female ratio of 7:3. The age range was 7 months to 5 years (mean age 2.3 years). All ten patients received postoperative elective ventilation for a period of 2-5 days (mean 3.5). Two patients had minor leaks from the neck wound that healed spontaneously. Mean hospital stay was 13 days with range 11-16 days. Two patients died one due to sepsis and 2nd on elective ventilation.
Conclusions: The gastric pull-up procedure for the isolated esophageal atresia is a good option with minimum complications and best results.

Key words: Isolated esophageal atresia, gastric pull-up,



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