Yuhua Shan and Qimin Chen*
Department of Pediatric Surgery, Shanghai Children?s? Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, ChinaFulltext PDF
Esophageal replacement can be the last resort when dilation is not effective in caustic ingestion cases. The jejunum, despite having many merits, is seldom chosen as a graft because it can increase the complexity of the surgery. This study aimed to propose a novel procedure of free jejunal transplantation using the internal mammary artery. A 13-year old boy developed progressive severe dysphagia caused by a caustic-induced long esophageal stricture 4 months after ingesting sulfuric acid. Dilation resulted in perforation; therefore, he had to resort to esophageal replacement. The free jejunum interposition was anatomized to the esophageal residues in orthotropic side to side way; the mesenteric vessels were anastmosed to internal mammary artery and zygote vein. The boy recovers in 2 weeks without presentation of stricture or reflux in the 6-month later follow-up. We conclude that the new technique is a potential way for long segment esophageal replacement.
Free jejunum interposition; Internal mammary artery; Caustic esophageal stricture
Shan Y, Chen Q. A Novel Surgical Procedure of Esophageal Replacement. Clin Surg. 2020; 5: 2986..