RT info:eu-repo/semantics/article
T1 Laparoscopic-assisted gastric pull-up: initial experience and technical details
A1 Gómez Culebras, Mario  Alberto
A1 Molino, J.A.
A1 Gine, C.
A1 Guillén, G.
A1 López-Fernández, S.
A1 Garcia, L.
A1 Rocha, O.
A1 Lain, A.
A1 Lloret, Josep
A1 Perez-Etchepare, E.
A1 López, Manuel
A2 Cirugía
K1 Esophageal atresia
K1 Long gap
K1 Caustic esophageal stricture
K1 Pediatric
K1 Laparoscopy
AB Aim To describe our initial experience in laparoscopic-assisted gastric pull-up via posterior mediastinal route in comparisonwith our historic experience performed by open laparotomy gastric pull-up via retrosternal route. The results of the twoapproaches were evaluated in this study.Materials and methods Between 2000 and 2017, we conducted a retrospective review of all patients that had undergonegastric transposition for esophageal atresia (EA) and long caustic strictures when preservation of the native esophaguswas  not possible.Results A total of 17 pediatric patients underwent gastric pull-up transposition as esophageal replacement technique. Thepatients were divided into two groups. Group A (2000–2015) consisted of 11 patients that underwent open laparotomy gastricpull-up via the retrosternal route. Three Group A patients had EA Type I, two had EA Type II, fve had EA Type III, and onelong caustic stricture. Associated anomalies included VACTERL association in two cases, Down syndrome in one case andintestinal malrotation in one case. The mean age at surgery was 2.2 years and the mean follow-up was 9.3 years. All patientswere able to achieve oral feeds. Group B (2016–2018) consisted of six patients that underwent laparoscopic-assisted gastrictransposition via posterior mediastinal pathway. Three had EA Type I, two had EA Type III, and one had a long causticesophageal stricture. Associated anomalies included a single case of VACTERL association. Previous surgeries includedtwo thoracotomies and two esophagostomies in patients with EA/TEF and one gastro-jejunal anastomosis in a patient withpyloric total disconnection after pyloric balloon dilatation for caustic esophageal and pyloric stricture. All patients underwentgastrostomy. Laparoscopic procedure was successfully completed in all patients without conversion. The mean follow-up inGroup B was 27 months. All patients were able to establish oral feeds.Conclusion Laparoscopic-assisted gastric pull-up as esophageal replacement technique is safe and has few complications.Slight modifcations of the technique such as pyloric dilation reduce laparoscopic surgical time.
YR 2020
FD 2020
LK http://riull.ull.es/xmlui/handle/915/34831
UL http://riull.ull.es/xmlui/handle/915/34831
LA en
NO Journal of Pediatric Endoscopic Surgery, 2020 Jun, Vol. 2: 55-60DOI: 10.1007/s42804-020-00049-7ISSN: 2524-7875 (print) / 2524-7883 (electronic)
DS Repositorio institucional de la Universidad de La Laguna
RD 25-nov-2024