Gastric Tube

Abstract

In children, esophageal substitution may be commonly required for cases of long gap esophageal atresia (LGEA) with or without tracheo-esophageal fistula (TEF), following diversion in esophageal atresia after failed repair and cases of corrosive stricture. Creation of a gastric tube, preserving nearly half the stomach in its anatomical location is an important technique of partial or complete esophageal replacement. It may be created in an isoperistaltic or reverse peristaltic fashion. The stomach reservoir can be further preserved using our previously described technique of fundal tube esophagoplasty where the native lower esophagus is also utilized to bridge the gap. Similar to other methods of esophageal replacement, this is a major procedure involving a long suture line. It could be associated with considerable morbidity in the immediate postoperative period as well as the first 1–2 years after surgery. The technique and complications seen in the author's own experience in children with esophageal atresia and their management are discussed.