ESOPHAGEAL REPLACEMENT IN INFANTS AND CHILDREN WITH USE OF A SEGMENT OF COLON

Abstract

A segment of colon is considered best for operative substitution of a damaged esophagus because it resists peptic ulceration, it functions well during swallowing, and its blood supply remains intact after transposition. Before a child is considered a candidate for the operation, conservative treatment should be done (dilatation for esophageal stricture, portal-systemic venous anastomosis for varices). The operation was performed successfully on six of nine infants with congenital esophageal atresia, four children with strictures from ingested lye, two with persistent esophagitis, and three with bleeding varices. Failure of the operative procedure was the cause of death in one child; in the others the cause was undetermined or unrelated. The technical difficulties of the transposition are encountered in the infant, and these can usually be obviated by delaying the operation until the child is 1 to 2 years old.