Abstract
Total gastric transposition for substitution of thoracic and abdominal esophagus was performed in two cases with complicated esophageal atresia with satisfactory functional results. Case 1 : 7-year-old boy with esophageal atresia without tracheoesophageal fistula whose lower esophagus was totally absent. Intrathoracic esophageal reconstruction with free jejunal graft was unsuccessful at age 5. At age 7 total gastric transposition via posterior mediastinal route introduced by Lewis Spitz was performed with success. No postoperative leakage nor stenosis was observed at the cervical esophagogastric anastomosis site. Case 2 : At neonatal period a primary repair for esophageal atresia with distal tracheoesophageal fistula was performed but esophageal intubation after an accidental extubation of the orotracheal tube caused a total rupture of the esophageal anastomosis and pyothorax. Later, congenital esophageal stenosis in distal esophagus was found, which required total esophageal reconstruction. After removing the lower esophagus and creation of cervical esophagostomy, the same procedure as in case 1 was performed successfully at age 15. The procedure released him from long lasting daily bouginage and semi solid food. This procedure is quite simple and relatively easy for salvage of complicated esophageal atresia and stenosis.
