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March 1957

One-Stage Retrosternal Esophagoplasty Using Right Side of Colon: Report of a Case of Late Reconstruction in Congenital Esophageal Atresia

Author Affiliations

Portland, Ore.
Department of Surgery, University of Oregon Medical School Hospitals and Clinics; Assistant Clinical Professor of Surgery (Dr. Nadal) and Resident in Surgery (Dr. Gustavson).

AMA Arch Surg. 1957;74(3):442-446. doi:10.1001/archsurg.1957.01280090140018

In esophageal atresia the treatment of choice usually includes primary anastomosis of the esophageal segments. However, in some patients the distance to be bridged is so great that primary anastomosis may be dangerous or impossible. When such a situation exists, the surgeon may choose to perform cervical esophagostomy and tube gastrostomy and defer esophageal reconstruction to a later date.

Esophageal replacement has been accomplished by utilizing stomach,1-3 jejunum,4-6 and skin tubes.7 Although the stomach can be mobilized adequately to permit its anastomosis to the cervical esophagus, an intrathoracic position may cause complications. Some of the more commonly reported complications following this procedure are chronic gastritis, esophagitis, stricture of the suture line, nausea, and, occasionally, respiratory disorders.

The use of jejunum in esophagoplasty has been investigated by Yudin,8 Longmire,9 Mes,10 and others. In this procedure the cardinal difficulty is centered about the jejunal vascular supply,

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