Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2012 Vol. 20 No 1

PEDIATRIC SURGERY

V.I. AVERIN 1, V.N. PODGAYSKY 2, L.N. NESTERUK 3, YU.M. GRINEVICH 1, A.F. RYLYUK 2

FIRST EXPERIENCE OF GRAFT REVASCULARIZATION AT ESOPHAGOPLASTY IN CHILDREN IN NON-STANDARD CASES

EE Belarusian State Medical University ¹,
SEE Belarusian Academy of Post-Graduate Education ²,
ME The First city clinical hospital, Childrens surgical center ³, Minsk
The Republic of Belarus

Objectives. To analyze the first experience of graft revascularization at esophagoplasty in children in non-standard cases.
Methods. In childrens surgical center (CSC) 5 children with the congenital and acquired esophagus pathologies were operated on. The technique of the additional graft vascularization was applied in 3 patients; free autotransplantation of the bowel segment with revascularization was carried out in 2 patients. The estimation of the operation as well as of early and late complications was done. There were no lethal outcomes.
Results. Nearest and distant results (from 3 to 10 months) were studied in all the patients. It was found out that the operations aiming to form the artificial esophagus with revascularization and additional vascularization of the bowel graft using microsurgical equipment permitted to complete successfully esophagoplasty in all children.
Conclusions. Operations when the artificial esophagus is formed with the bowel graft revascularization using microsurgical equipment may be successfully used both for the primary reconstruction of the upper sections of the alimentary tract and for the secondary reconstruction anaboly forming to finish unsuccessful sub- and total esophagoplasty.

Keywords: esophagoplasty, revascularization, graft, children
p. 80 84 of the original issue
References

1.Isakov IuF, Stepanov EA, Razumovskii AIu, Bataev SK, Romanov AV, Kuleshov BV, Beliaeva ID. Iskusstvennyi pishchevod u detei [Artificial esophagus in children]. Khirurgiia. 2003;(7):616.
2.Smirnov AK. Koloezofagoplastika u detei [Coloesophagoplasty in children]. Det Khirurgiia. 2009;(3):1719.
3.Ergun O, Celik A, Mutaf O. Two-stage coloesophagoplasty in children with caustic burns of the esophagus: hemodynamic basis of delayed cervical anastomosis theory or fact. J Ped Surg. 2004;39(4):54548.
4.Bassiouny IE, Al-Ramadan SA, Al-Nady A. Long-term functional results of transhiatal oesophagestomy and colonic interposition for caustic oesophageal stricture. Eur J Pediatr Surg. 2002;12(4):24347.
5.Chepurnoi GI, Miasnikov AG, Rozin BG. Sheinyi ezofagokoloanastomoz pri total'noi plastike pishchevoda u detei [Cervical esophagocoloanastomosis with total plastic of esophagus in children]. Det Khirurg. 2004;(3):45.
6.Appignani A, Lauro V, Prestipino M, Centonze N, Domini R. Intesninal bypass of the oesophagus: 117 patients in 28 years. Pediatr Surg Int. 2000;16(5-6):32628.
7.Page RD, Shackcloth MJ, Russell GN, Pennefather SH. Surgical treatment of anastomotic leaks after oesophagectomy. Eur J Cardiothorac Surg. 2005;(27):33743.
8.Tabira Y, Sakaguchi T, Kuhara H, Teshima K, Tanaka M, Kawasuji M.The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg. 2005;189(3):41721.
9.Cherniavskii AA, Ryzhov MK. Vybor sposoba zaversheniia izoperistal'ticheskoi trubchatoi ezofagoplastiki na osnovanii intraoperatsionnoi otsenki krovosnabzheniia zheludochnogo transplantata [Choice of the method of isoperistaltic tubular esophagogastroplasty on the basis of intraoperative assessment of gastric graft blood supply]. Khirurgiia. 2008;(2):2632.
10.Belousov EV, Baitinger BF. Prichiny nesostoiatel'nosti pishchevodno-kishechnykh anastomozov na shee [Causes of incompetence of esophago-intestinal anastomoses in the neck]. Khirurgiia. 1984;(10):7679.
11.Chepurnoi GI. Pishchevodno-tolstokishechnyi anastomoz na shee pri ezofagoplastike u detei [Cervical esophageal-colon anastomosis in children with esophagoplasty]. Det Khirurgiia. 2006;(5):1721.
12.Hadidi AT. A technique to improve vascularity in colon replacement of the esophagus. Eu J Pediatr Surg. 2006;16(1):3944.
13.Abakumov MM, Pogodina AN, Khaliullin AI. Profilaktika nekrozov tolstokishechnogo transplantata pri ezofagoplastike [Prevention of necrosis of the colonic graft in esophagoplasty]. Khirurgiia Legkikh i Pishchevoda: tez. dokl. rasshiren plenuma problemnoi komissii Grudnaia Khirurgiia. Vitebsk, RB; 1988. p. 45.
14.Hirschl RB, Yardeni D, Oldham K, Sherman N, Siplovich L, Gross E, Udassin R, Cohen Z, Nagar H, Geiger JD, Coran AG. Gastric transposition for esophageal replacement in children: experience with 41 consecutive cases with special emphasis on esophageal atresia. Ann Surg. 2002;236(4):53141. discussion 53941.
15.Drobiazgin EA. Lechenie striktur pishchevodnykh anastomozov [Treatment of esophageal anastomotic strictures]. MKhZh. 2009;(5):2325.
16.Sakuraba M, Kimata Y, Hishinuma S, Nishimura M, Gotohda N, Ebihara S. Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy. Plast Reconstr Surg. 2004;113(7):193439.
17.Zonta A, Visconti FE, Dionigi P, Vai L, Avanzi MS, Mourad Z, Perosin D, Fraipont G, Guizzetti M, Aluffi A, Ciccone R, Perego M, Alvisi C, Passera R. Internal mammary blood supply for ileo-colon interposition in esophagogastroplasty: a case report. Microsurgery. 1998;18(8):47275.
18.Chepik DA. Sovremennye napravleniia plastiki pishchevoda u bol'nykh s posleozhogovymi rubtsovymi strikturami pishchevoda [The current trends of esophagus plastic in patients with post-burn cicatricial strictures of the esophagus]. Novosti Khirurgii. 2009;17(3):15467.
19.Ryliuk AF. Topograficheskaia anatomiia i khirurgiia organov briushnoi polosti [Topographic anatomy and surgery of the abdominal cavity]. Minsk, RB: Vysh shk; 1997. 319 p.

Address for correspondence:
220116, Respublika Belarus', g. Minsk, pr-t. Dzerzhinskogo, d. 83, UO Belorusskii gosudarstvennyi meditsinskii universitet, kafedra detskoi khirurgii,
e-mail: averinvi@mail.ru,
Averin Vasilii Ivanovich
Information about the authors:
Averin V.I. Doctor of medical sciences, professor, head of the pediatric surgery chair of EE Belarusian State Medical University.
Podgaysky V.N. Doctor of medical sciences, professor of surgery chair of SEE Belarusian Academy of Post-Graduate Education.
Nesteruk I.N. Surgeon of the ME The First City Clinical Hospital, Childrens Surgical Center
Grinevich Yu.M. Candidate of medical sciences, associate professor of the pediatric surgery chair of EE Belarusian State Medical University.
Rylyuk A.F. Doctor of medical sciences, professor of surgery chair of SEE Belarusian Academy of Post-Graduate Education.
Contacts | ©Vitebsk State Medical University, 2007