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Laparoscopic Transhiatal Gastric Transposition Preserving the Abdominal Esophagus for Long Gap Esophageal Atresia (Abstract)

Nguyen Thanh Liem, Bui Duc Hau, Le Anh Dung

Department of Surgery

National Hospital of Pediatrics

Hanoi, Vietnam

 

Abstract

We report the technique of laparoscopic transhiatal gastric transposition preserving the abdominal esophagus for long gap esophageal atresia. A 4-day old boy with Down syndrome had a long gap esophageal atresia. A gastrostomy and cervical esophagostomy were performed. Esophageal replacement was carried out at the age of 9 months. The operation was performed laparoscopically including complete mobilization of the stomach and lower esophageal stump, pyloroplasty and creation of posterior mediastinal route. The gastric pull-up was performed. The upper anastomosis between cervical esophagus and abdominal esophagus was completed with interrupted 5/0 PDS sutures. The duration of the operation was 4.5 hours. A leakage of the esophago-esophageal anastomosis occurred on day 5 postoperatively and was resolved spontaneously. Postoperative esophagogram showed a wide anastomosis and good gastric empty. Patient was discharged after 3 weeks. Laparoscopic transhiatal gastric transposition preserving the abdominal esophagus for long gap esophageal atresia is a safe and physiologic procedure.

Key words: esophageal atresia, laparoscopic gastric transposition

 

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