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Pediatric esophageal substitution by gastric pull-up and gastric tube

AIM: The aim of this study was to report the results of pediatric esophageal substitution by gastric pull-up (GPU) and gastric tube (GT) from a tertiary care pediatric center. MATERIALS AND METHODS: Retrospective analysis of the surgical techniques, results, complications, and final outcome of all p...

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Autores principales: Choudhury, Subhasis Roy, Yadav, Partap Singh, Khan, Niyaz Ahmed, Shah, Shalu, Debnath, Pinaki Ranjan, Kumar, Virendra, Chadha, Rajiv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4895733/
https://www.ncbi.nlm.nih.gov/pubmed/27365902
http://dx.doi.org/10.4103/0971-9261.182582
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author Choudhury, Subhasis Roy
Yadav, Partap Singh
Khan, Niyaz Ahmed
Shah, Shalu
Debnath, Pinaki Ranjan
Kumar, Virendra
Chadha, Rajiv
author_facet Choudhury, Subhasis Roy
Yadav, Partap Singh
Khan, Niyaz Ahmed
Shah, Shalu
Debnath, Pinaki Ranjan
Kumar, Virendra
Chadha, Rajiv
author_sort Choudhury, Subhasis Roy
collection PubMed
description AIM: The aim of this study was to report the results of pediatric esophageal substitution by gastric pull-up (GPU) and gastric tube (GT) from a tertiary care pediatric center. MATERIALS AND METHODS: Retrospective analysis of the surgical techniques, results, complications, and final outcome of all pediatric patients who underwent esophageal substitution in a single institution was performed. RESULTS: Twenty-four esophageal substitutions were performed over 15-year period. The indications were pure esophageal atresia (EA)-19, EA with distal trachea-esophageal fistula-2, EA with proximal pouch fistula-1, and esophageal stricture in two patients. Mean age and weight at operation were 17 months and 9.5 kg, respectively. GPU was the most common procedure (19) followed by reverse GT (4) and gastric fundal tube (1). Posterior mediastinal and retrosternal routes were used in 17 and 7 cases, respectively. Major complications included three deaths in GPU cases resulting from postoperative tachyarrhythmias leading to cardiac arrest, cervical anastomotic leak-17, and anastomotic stricture in six cases. Perioperative tachyarrhythmias (10/19) and transient hypertension (2/19) were observed in GPU patients, and they were managed with beta blocker drugs. Postoperative ventilation in Intensive Care Unit was performed for all GPU, but none of the GT patients. Follow-up ranged from 6 months to 15 years that showed short-term feeding difficulties and no major growth-related problems. CONCLUSIONS: Perioperative tachyarrhythmias are common following GPU which mandates close intensive care monitoring with ventilation and judicious use of beta blocking drugs. Retrosternal GT with a staged neck anastomosis can be performed without postoperative ventilation.
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spelling pubmed-48957332016-07-01 Pediatric esophageal substitution by gastric pull-up and gastric tube Choudhury, Subhasis Roy Yadav, Partap Singh Khan, Niyaz Ahmed Shah, Shalu Debnath, Pinaki Ranjan Kumar, Virendra Chadha, Rajiv J Indian Assoc Pediatr Surg Original Article AIM: The aim of this study was to report the results of pediatric esophageal substitution by gastric pull-up (GPU) and gastric tube (GT) from a tertiary care pediatric center. MATERIALS AND METHODS: Retrospective analysis of the surgical techniques, results, complications, and final outcome of all pediatric patients who underwent esophageal substitution in a single institution was performed. RESULTS: Twenty-four esophageal substitutions were performed over 15-year period. The indications were pure esophageal atresia (EA)-19, EA with distal trachea-esophageal fistula-2, EA with proximal pouch fistula-1, and esophageal stricture in two patients. Mean age and weight at operation were 17 months and 9.5 kg, respectively. GPU was the most common procedure (19) followed by reverse GT (4) and gastric fundal tube (1). Posterior mediastinal and retrosternal routes were used in 17 and 7 cases, respectively. Major complications included three deaths in GPU cases resulting from postoperative tachyarrhythmias leading to cardiac arrest, cervical anastomotic leak-17, and anastomotic stricture in six cases. Perioperative tachyarrhythmias (10/19) and transient hypertension (2/19) were observed in GPU patients, and they were managed with beta blocker drugs. Postoperative ventilation in Intensive Care Unit was performed for all GPU, but none of the GT patients. Follow-up ranged from 6 months to 15 years that showed short-term feeding difficulties and no major growth-related problems. CONCLUSIONS: Perioperative tachyarrhythmias are common following GPU which mandates close intensive care monitoring with ventilation and judicious use of beta blocking drugs. Retrosternal GT with a staged neck anastomosis can be performed without postoperative ventilation. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4895733/ /pubmed/27365902 http://dx.doi.org/10.4103/0971-9261.182582 Text en Copyright: © Journal of Indian Association of Pediatric Surgeons http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Choudhury, Subhasis Roy
Yadav, Partap Singh
Khan, Niyaz Ahmed
Shah, Shalu
Debnath, Pinaki Ranjan
Kumar, Virendra
Chadha, Rajiv
Pediatric esophageal substitution by gastric pull-up and gastric tube
title Pediatric esophageal substitution by gastric pull-up and gastric tube
title_full Pediatric esophageal substitution by gastric pull-up and gastric tube
title_fullStr Pediatric esophageal substitution by gastric pull-up and gastric tube
title_full_unstemmed Pediatric esophageal substitution by gastric pull-up and gastric tube
title_short Pediatric esophageal substitution by gastric pull-up and gastric tube
title_sort pediatric esophageal substitution by gastric pull-up and gastric tube
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4895733/
https://www.ncbi.nlm.nih.gov/pubmed/27365902
http://dx.doi.org/10.4103/0971-9261.182582
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