Esophageal Preservation and Replacement in Children

Preface
Contents
Contributors
Part I: Anatomy and Physiology of Esophagus
	1: Anatomy and Embryology of the Esophagus
		Anatomy
		Embryologic Development
			Separation of Trachea and Esophagus
			Transition from Columnar to Squamous Epithelium
			Muscle Development
		References
	2: Physiology and Motility of the Normal and Replaced Esophagus
		The Structure of the Esophagus
			Gross Anatomy
			The Enteric Nervous System (ENS)
		The Physiology of the Esophagus
		The Esophageal Function and Motility
		Common Surgical Esophageal Motility Disorders
			Esophageal Atresia and Tracheoesophageal Fistula
			Caustic Ingestion
			Motor Function of the Replaced Esophagus
				Gastric Interposition
				Colonic Interposition
				Jejunal and Ileal Interposition
		Summary
		References
Part II: Techniques for Preservation of Native Esophagus (LGEA)
	3: Intrathoracic Extracorporeal Lengthening (Foker technique)
		General Background
		Elongation Techniques
			Continuous Stretching
			Foker’s Intrathoracic Elongation
			Open Foker Technique
			Minimally Invasive Foker Technique
			Our Experience
			Intrathoracic Elongation During Primary Esophagoesophagostomy (EA-TEF)
				Esophageal Myotomy
				Gough’s Flap
		Nonsurgical Treatment
			Clostridium botulinum Neurotoxin A
		References
	4: Intrathoracic Intracorporeal Thoracoscopic Elongation – External Traction
		Introduction
		Preoperative Assessment and Preparation
		Anesthesia
		Thoracoscopic Procedure
		Laparoscopic Gastropexy
		Postoperative Care
		Thoracoscopic Anastomosis
		Postoperative Care
		Outcome
		Further Reading
	5: Intrathoracic Intracorporeal Thoracoscopic Elongation – Internal Traction
		Preoperative Workup and Considerations
		Surgical Algorithm for LGEA
		Thoracoscopy for LGEA Patient’s Treatment
		Anesthesia Considerations
			Equipment Needed
			Patient’s Positioning
			Trocar Placement and Preparation of the Operative Field
			Postoperative Care
		Complications of LGEA Repair
			Anastomotic Leakage
			Anastomotic Stenosis
			Swallowing Difficulties
		References
	6: Extrathoracic Lengthening (Kimura Technique)
		Introduction
		Indications: Advantages and Disadvantages
			Advantages
			Disadvantages
		Technique
			Single Versus Multistaged Lengthening
			Technical Pitfalls
		Results and Long-Term Follow-Up
		Discussion
		Conclusion
		References
Part III: Indications for Esophageal Replacement and Routes for Esophageal Replacement
	7: Long Gap Esophageal Atresia
		Introduction
		Conclusion
		References
	8: Caustic Esophageal Injuries, GER Strictures and Postoperative Strictures
		Introduction
			Caustic Ingestion
				Other Indications for Esophageal Replacement for Children
					End-Stage Esophagus
					Post-esophageal Surgery Strictures
		Esophageal Replacement Conduits
		Summary
		References
	9: Routes for Oesophageal Replacement
		Trans-hiatal Route/Posterior Mediastinal Route
		Substernal/Retrosternal Route
		Subcutaneous/Ante-sternal Route
		Trans-pleural/Intra-pleural Route
		Conclusion
		References
Part IV: Gastric Substitution
	10: Gastric Tube
		Introduction
		Gastrostomy Technique and Management After Cervical Esophagostomy and Gastrostomy
		When to Perform Gastric Tube Esophageal Replacement
		Preoperative Investigations
		Admission and Preoperative Preparation
		Laparotomy
		Technique of Fundal Tube Esophagoplasty
		Technique of Reverse Gastric Tube Esophagoplasty
		Route for Neo-esophagus
		Esophageal Anastomosis
		Closure of Stomach
		Fundoplication
		Postoperative Care
		Postoperative Feeding Protocol
		Follow-Up After Discharge
		Our Experience
		Additional Procedures Following First Stage of Two-Stage Procedure
		Additional Procedures During Single-Stage Procedure
		Early Postoperative Complications
		Late Postoperative Complications and Long-Term Follow-Up
		Discussion
		Conclusions
		References
	11: Gastric Pull Up: Open Approach
		Introduction
		Indications
		Routes for Esophageal Replacement
		Surgical Anatomy of the Stomach
		Blood Supply of the Stomach
		Surgical Technique
		Postoperative Care
		Why Choose Gastric Pull Up?
			Benefits
			Drawbacks
		Outcomes
			Respiratory Compromise
			Death/Mortality
			Anastomotic Leaks
			Anastomotic Strictures
			Swallowing Difficulties
			Gastroesophageal Reflux
			Dumping Syndrome
			Delayed Gastric Emptying
			Redo Surgery
			Jejunostomy-Related Complications
			Growth (Height and Weight)
			Quality of Life Assessment
			Neonatal Gastric Pull Up
		References
	12: Gastric Pull Combined Laparoscopic and Thoracoscopic Approach
		Introduction
		Surgical Technique
		Comparison of Outcomes MIS Versus Open Gastric Pull Up
		References
Part V: Jejunal and Colonic Substitution
	13: Vascularized Jejunal Tube
		History
		Principles and Justification
		Preoperative Assessment and Preparation
		Anesthesia
		Operation
		Postoperative Care
		Outcome
		References
	14: Super Charged Jejunal Tube (Microvascular Anastomosis)
		History
		Indications and Considerations
		Preoperative Assessment
			Initial Patient Evaluation
			Surgical Timing
		Surgical Technique
			Sternotomy and Neck Dissection
			Mobilizing the Jejunal Conduit
			Supercharging
			Restoration of Intestinal Continuity
		SPJI Outcomes
			Overview
			Anastomotic Leak
			Stricture
			Reflux
			Respiratory Function
			Redundancy/Tortuosity
			Nutritive Intake and Feeding Status
			Conduit Survival and Necrosis
			Mortality
		Limitations
			Surgical Complexity
			Limited Pediatric Literature
		Conclusion
		References
	15: Colonic Substitution
		History
		Colon as a Substitute of Esophagus
		Timing of CS
		Preparation Before CS
		Surgical Technique
			Modifications of Surgical Techniques
		Complications of CS
		Long-Term Outcome After CS
		References
Part VI: Comparative Outcomes of ER Techniques and Future of ER
	16: Comparative Outcomes of Esophageal Replacement Techniques
		Introduction
			Pros and Cons of Different ER Options
			Comparison of Outcomes of Different ER Procedures
			Minor Complications
			Major Complications
			Long-Term Gastrointestinal Complications
			Long-Term Respiratory Complications
			Development and Growth
			Quality of Life
		Conclusion
		References
	17: Tissue Engineering of Esophagus
		Introduction
		Tissue Engineering and Regenerative Medicine
		Components of Tissue Engineering
			Sourcing of Cells
			Scaffolds and Polymers
			Hybrid Constructs
			Bioreactors
		Tissue Engineering of the Esophagus
		Selection of Experimental Model
		Esophageal Epithelial Cells
		Esophageal Smooth Muscle Cells
		Esophageal Nervous System
		Esophageal Submucosal Glands
		Scaffolds
		Bioreactor and Tissue Generation
		Fetal Approach to Esophagus Tissue Engineering
		Conclusion
		References
	18: Future of Esophageal Preservation and Replacement
		Innovative Surgical Techniques
		Magnets
		Esophageal Lengthening Devices
		References
Index