Seventy Cases of Partial Gastric Pull-Up According to the Schärli Technique for Esophageal Replacement in Pediatrics

Martín Rubio, Mariano Boglione*, Carlos Fraire, Silvia Takeda, Cristian Weyersberg, Fermín Prieto and Marcelo Barrenechea

Seventy Cases of Partial Gastric Pull-Up According to the Schärli Technique for Esophageal Replacement in Pediatrics.

The resolution of complex esophageal atresia (EA) and esophageal strictures that are resistant to conservative treatment with dilations is challenging and remains controversial. Although, it is
widely accepted in the literature that the esophagus itself is the best option for complex esophageal pathologies,1,2 there are certain circumstances in which loss of the organ is unavoidable and esophageal replacement (ER) is necessary. The ideal esophageal substitute should conform in function as far as possible to the original structure. The patient should be able to swallow normally and experience no reflux symptoms. An additional requisition in children is that the substitute should continue functioning for many decades without deterioration. There is no perfect method for esophageal replacement due to the complexity of its reconstruction.

Most of the indications for ER are long gap esophageal atresia (LGEA) or severe anastomotic complications that end in the loss of the organ; and caustic (CS) or peptic strictures resistant to conservative treatment with medication and periodic dilations.

Gastric necrosis, number of reoperations (related to the ER procedure), death, and follow-up in years were also considered. Enteral feeding status was verified at the time of this review. We define dehiscence of the anastomosis by observation of saliva through the cervical wound or leakage of contrast material during esophagogram.

The objective of this report is to analyze the evolution of a group of patients with complex esophageal pathology.

Pediatr Neonatal Nurs Open J. 2020; 7(1): 1-7. doi: 10.17140/PNNOJ-7-131