抄録
Between 1980 and 1985, the wide gap esophageal atresia was successfully repaired in five infants with circular myotomy (Livaditis technique) and end-to-end anastomosis. Three infants required one myotomy to overbridge the gaps between esophageal ends, one infant required two myotomies, and the rest one required three myotomies. Those five children one to six (mean 5) years after surgery, have been evaluated by clinical examination and esophageal function tests, including cinefluorography, manometory, pH monitoring, and endoscopic observation. The excellent results had achieved in a child who had been myotomized at her neonatal period. Swallowing and esophageal motility had been good in another two children who had also received single myotomy to overbridge the gaps of 2 to 2.5 cm. In the remaining two children who had received multiple myotomies, marked disturbances of esophageal motility had demonstrated. Those two boys had required antireflux surgery consequently. Previous x-rays had shown varying degrees of esophageal "ballooning" at the myotomy sites in all, but those balloonings had been decreasing in size to a certain degree. We feel that complications or dysadvantages directly related to the myotomy are minimal in cases the only one myotomy required and esophageal function is similar to other children who have had esophageal atresia repair. Children who have required multiple myotomies overbridging the wider gaps, will necessary to train eating persistently for a long term after surgery.
