The Outcomes of Different Surgical Techniques for Esophageal Replacement in Children with Caustic Injury

Caustic esophageal injuries often lead to severe strictures untreatable with endoscopic methods which necessitate surgical interventions. The aim of this study was to evaluate the outcomes and efficacy of these different techniques including trans-hiatal gastric pull up, gastric pull up via thoracotomy, reverse gastric tube, and colonic interposition and compare their complications.

This reto- and prospective study was conducted from 2014 onward at Mofid Children Hospital in Tehran. Data of patients who had undergone esophageal replacement surgery from 2007 to 2017 was retro- and prospectively retrieved from the hospital archives and the newly referred patients during the study. Required data were extracted from medical records. Data analysis was performed with SPSS 21 software package.

27 patients (mean age: 4.01 years, 59.3% males) were included in this survey. Average time from ingestion to surgery was 8.44 months. All patients had dysphagia. 5.8 sessions of endoscopic dilatation were performed for each patient, on average. 70.4% of patients underwent thoracotomy and gastric pull-up. ICU stay duration was 6.88 and time to extubation was 2.25 days. The most common complication was post-discharge stricture. Surgical methods were all the same regarding different parameters except post-discharge stricture and iatrogenic esophageal perforation.

Overally, surgical methods did not differ in terms of outcomes and complications.