ОBVIATION OF DIASTASIS BETWEEN COLON END AND ESOPHAGUS DURING THE NECK ANASTOMOSIS FORMATION IN CASE OF ESOPHAGOPLASTY IN CHILDREN WITH ESOPHAGEAL ATRESIA

Abstract

Purpose: To improve coloesophagoplasty outcomes in children with esophageal atresia when diastasis between the colon and neck part of esophagus came to 3.0 cm by lengthening the last one.

Materials and Methods: A new method of esophagomyotomy using only longitudinal muscle fibers dissection was developed experimentally. This method was applied to perform an esophagoplasty in 3 children with primary-made double esophagostomy. The “end-to-end” esophagocoloanastomosis and presternum resections were made in all cases.

Results: Keeping the circulatory muscle layer intact allows to avoid submucosal vessel’s damage, esophageal diverticula’s formation and to facilitate surgeon’s work, to decrease a period of operation. Two neck anastomoses were healed without fistula’s formation, one girl developed anastomosis inconsistency, so separation of anastomosis was made for a 6-month period with followed-up raconsruction.

Summary: The neck part of esophagus elongation using Livaditis-Kimura esophagomyotomy in cases of coloesophagoplasty in children with esophageal atresia can be used as alternative method to eliminate diastasis between ends of colon and esophagus up to 3.0 cm.