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Functional, nutritional, and developmental assessment of gastric transposition and colonic interposition: Long-term follow-up outcome analysis

  • Author Footnotes
    1 Department of Pediatric Surgery, Institute of Medical Sciences-Banaras Hindu University, Varanasi 221005, India
    Kanika Sharma
    Footnotes
    1 Department of Pediatric Surgery, Institute of Medical Sciences-Banaras Hindu University, Varanasi 221005, India
    Affiliations
    Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
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  • Shilpa Sharma
    Correspondence
    Corresponding author.
    Affiliations
    Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
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  • Author Footnotes
    2 Super specialty Pediatric Hospital & Postgraduate Teaching Institute, Sector-30, Noida 201303, India
    Devendra Kumar Gupta
    Footnotes
    2 Super specialty Pediatric Hospital & Postgraduate Teaching Institute, Sector-30, Noida 201303, India
    Affiliations
    Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
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  • Sushil Kumar Kabra
    Affiliations
    Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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  • Minu Bajpai
    Affiliations
    Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001, 4th floor, Academic block, New Delhi 110029, India
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  • Author Footnotes
    1 Department of Pediatric Surgery, Institute of Medical Sciences-Banaras Hindu University, Varanasi 221005, India
    2 Super specialty Pediatric Hospital & Postgraduate Teaching Institute, Sector-30, Noida 201303, India

      Abstract

      Purpose

      The choice of Esophageal replacement (ER) depends on surgeons’ preference and patients’ anatomical condition. A cross-sectional study was done to compare the long-term outcomes of two methods of ER, Gastric transposition (GT) and Colonic interposition (CI).

      Methods

      Children who had undergone ER from January 1997 to December 2017 with a minimum of two-year post-ER follow-up were evaluated by anthropometry, hepatobiliary scintigraphy, gastroesophageal reflux study, gastric emptying test, pulmonary function test and blood tests.

      Results

      Twenty-six (Male:female=17:9) children were recruited. The median age at ER was 13 months (interquartile range 9–40 months) and mean follow-up post-ER was 116.7 ± 76.4 months (range 24–247 months). GT:CI was done in 15(57.7%):11(42.3%) cases. A greater number of abnormal oral contrast studies (p = 0.02) and re-operations (p = 0.05) were documented as baseline characteristics with CI group. The presence of gastroesophageal reflux 9/23(39.1%), duodenogastric reflux 6/24(25%), delayed gastric emptying 6/25(24%), abnormal pulmonary function test 14/22(63.6%) were documented during the study period. However, there was no significant(p>0.05) difference in nutritional, developmental and functional outcomes of both operative methods of ER in the study.

      Conclusion

      Assessment of nutritional, developmental and functional parameters in children after ER reveals good long-term results. There was no significant difference in CI and GT.

      Level of evidence

      Comparative study; II

      Keywords

      Abbreviations:

      EA (Congenital Esophageal atresia), ER (Esophageal replacement), CI (Colonic Interposition), CIN (Corrosive injury), DGR (Duodenogastric reflux), GER (Gastroesophageal reflux), GET (Gastric emptying time), GT (Gastric Transposition)
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