Esophageal Reconstruction Using the Stomach for Tracheal Agenesis and Complicated Long-gap Esophageal Atresia

Abstract

There are many techniques for esophageal reconstruction for congenital esophageal atresia and tracheal agenesis, for which there is no standard treatment. We present three cases of esophageal reconstruction using part of the stomach as a substitute esophagus. Case 1 was a three-year-old boy who underwent lower esophageal banding, gastrostomy, and dissection of the cervical esophagus for Floyd’s type 1 tracheal agenesis. Esophageal reconstruction was performed using a gastric tube through the retrosternal route. Case 2 was a 10-month-old girl who underwent fistulotomy and salivary fistula for Gross B esophageal atresia. Esophageal reconstruction by the Collis–Nissen technique was performed. Case 3 was a two-year-old boy who developed mediastinal abscess after dilatation of anastomotic stricture after radical surgery for Gross C esophageal atresia. Esophageal reconstruction was performed using a total gastric tube through the retrosternal route. Although anastomotic leakage was observed in all the patients, it was improved by conservative treatment. It is necessary to select the useful technique and approach for esophageal reconstruction according to the individual cases.