Ashjaei Bahar,Movahedi Jadid  Merisa,Parvizi  Azita,Talebi  Ali,
What is the Best Choice for Esophageal Replacement in Children?
American Journal of Surgical Case Reports
2020
2674-5046
http://dx.doi.org/10.31487/j.AJSCR.2020.02.10
https://www.sciencerepository.org/what-is-the-best-choice-for-esophageal-replacement-in-children_AJSCR-2020-2-110 
Abstract: Esophageal replacement surgery is performed in children with either congenital long gap esophageal atresia
or acquired esophageal damages such as caustic injury of the esophagus. although the left colon because of
less variation in blood supply and suitable diameter in comparison with right colon is the better choice. A
secured pedicled colon is mandatory for reducing the sever complications, such as leak and necrosis.
Ileocolic conduit is an alternative method of colon interposition which has anti reflux effect and therefore
with less complications related to gastroesophageal reflux. When we have a short segment esophageal
stricture due to corrosive esophagitis or other causes of esophageal strictures which is refractory to repeated
dilatations, it is advisable to perform colon patch esophagoplasty. Gastric transposition can produce a good
way for gastrointestinal continuity with a perfect weight gain and oral feeding, therefor it can be a safe
choice for esophageal replacement in children. Partial gastric pull-up is an alternative operation for
esophageal replacement in children and infants with long gap esophageal atresia. Gastric conduit
replacement is another alternative technique for esophageal replacement, in which a gastric tube is created
in the abdomen and it is pulled to via thoracic cavity to the neck and is committed by cervical anastomosis.
Antral patch esophagoplasty is used for benign and limited esophageal stricture due to gastroesophageal
reflux. Usefulness of pedicled jejunum was under optimal results because of technical problems and high
rate of necrosis and mortality for decades. Sternocleidomastoid myocutaneous esophagoplasty is a scarce
method which is reported by some surgeons for limited cervical esophageal stricture repair. Free
microvascular transfer of the reverse ileo-colon flap with ileocaecal valve valvuloplasty is used for
reconstruction of a pharyngoesophageal defect, and Patch esophagoplasty by using of degradable
bioscaffolds of extracellular matrix have shown good results in preclinical and clinical outcomes to prevent
stenosis after endoscopic mucosectomy. We will explain the advantages and disadvantages of these different
surgical methods in this review article.Keywords: Esophageal replacement, colon interposition, gastric pull up, colon patch, gastric tube, jejunal interposition