Total Laparoscopic Approach for Transhiatal Esophagectomy and Gavriliu's Esophagoplasty in Children with Caustic Esophageal Injuries

Montalva, Louise; Viala, Jérôme; Michelet, D.; Frade, F.; Lardy, H.; Vitoux, C.; Bonnard, Arnaud

doi:10.1089/lap.2017.0053

Cited by 5 publications

(13 citation statements)

References 17 publications

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“…One case in this series has already been reported 30 for the treatment of esophageal caustic wounds. We did not find other cases of robotic esophagoplasty in the literature.…”

Section: Discussionmentioning

confidence: 85%

The Potential and the Limitations of Esophageal Robotic Surgery in Children

et al. 2020

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Introduction There have been numerous reports of robotic pediatric surgery in the literature, particularly regarding urological procedures for school-aged children. Thoracic procedures appear to be less common, despite the fact that encouraging results were reported more than 10 years. Our aim was to report a national experience of esophageal robotic-assisted thoracoscopic surgery (ERATS) and to discuss the most appropriate indications. Materials and Methods A retrospective multicenter study was conducted to compile the ERATS performed at five French surgical centers that have been involved in spearheading robotic pediatric surgery over the past 15 years. The data were supplemented by a review of the literature. Results Over the study period, 68 cases of robotic thoracic surgery were performed at the five pediatric centers in question. ERATS was performed for 18 patients (mean age 7.1 years [ ± 5.6]) in four of the centers. These comprised seven esophageal duplications, four esophageal atresias, five Heller's myotomies, and two cases of esophagoplasty. A conversion was needed for two neonates (11%) due to exposure difficulties. Four other procedures for patients who weighed less than 15 kg were successfully completed without causing postoperative complications. In the past 12 years, 22 other cases of ERATS were published worldwide. The indications were the same, except for esophagoplasty, which was not found. Conclusion Aside from accessibility issues with the robotic platform, the main limitation is still very much that the low body weight of children results in incompatibility between the size of the trocars and the size of the intercostal space. ERATS is clearly a feasible procedure with technical advantages for most pediatric cases with body weights more than 15 kg. A transdiaphragmatic abdominal approach should be considered for lower esophagus surgery.

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“…One case in this series has already been reported 30 for the treatment of esophageal caustic wounds. We did not find other cases of robotic esophagoplasty in the literature.…”

Section: Discussionmentioning

confidence: 85%

The Potential and the Limitations of Esophageal Robotic Surgery in Children

et al. 2020

Self Cite

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“…It entails no organ sacrifice and is less prone to tortuosity. [ 31 ] Stomach may also be used after proximal gastrectomy, but such conduits are found wanting in length. [ 25 ] Stomach is sturdy, quick to mobilise, easy to form a conduit on a dependable vasculature and entails a single anastomosis.…”

Section: Resultsmentioning

confidence: 99%

“…Hence, the anastomosis constructed there is prone to leaks, strictures and fistulae (detailed later) [ Table 2 ]. [ 14 , 31 , 51 ]…”

Section: Resultsmentioning

confidence: 99%

Minimal access surgery of corrosive and thermal strictures of the foregut

Vasudevan

Banerjee

Ghosh³

et al. 2023

Journal of Minimal Access Surgery

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Background and Aim: Conventional surgery for caustic/thermal strictures (CS/TS) entails considerable trauma, which may be mitigated by minimal access surgery (MAS). Experience with its use in CS/TS is both heterogeneous and limited, hence, warrants a comprehensive review. Methods: Medical literature/indexing databases were systematically searched for pertinent articles published in English, from 1990 to 2021, and analysed. Results: Fifty relevant articles, pertaining to over 200 patients, were found. They showed that MAS is feasible in CS/TS management. It reduces the access damage in chest and abdomen whilst facilitating resection or bypass of the affected gut segment through different combination of operations, sequence of steps, conduits and routes. The procedures range from completely minimal access to hybrid ones, with reduced complications and faster recovery. Hybrid procedures prove as expeditious as open ones. Conclusions: MAS proves efficacious in restoring alimentary continuity in corrosive/thermal strictures of the foregut.

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“…Repeated surgical intervention was needed in 43% of these children because of a nonfunctional gastric tube of for anastomosis revision. At 51-month followup, 85.7% of these patients were tolerating oral feeding (Montalva et al 2017).…”

Section: Surgical Interventionsmentioning

confidence: 97%

“…Factors predicting a fatal outcome were gastrointestinal tract perforation (Odd Ratio ¼ 13.5; p ¼ 0.011) and the need for an unscheduled re-operation (Odds Ratio ¼ 13.2; p ¼ 0.033) (Chang et al 2018). Montalva et al (2017) described 7 pediatric patients with corrosive substance ingestion treated surgically with total laparoscopic transhiatal esophagectomy and Gavriliu's esophagoplasty. Of these children, 2 were able to resume oral feeding following barium swallow evaluation on post-operative day 7.…”

Section: Surgical Interventionsmentioning

confidence: 99%

Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

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Corrosive chemical substance ingestions are a major problem, especially in developing countries, but also in developed countries such as the United States, France, and Belgium. Ingestions may be deliberate as suicide attempts (mostly in adolescents and adults) or accidental (mostly in children). The results can be devastating in terms of individual suffering and disability, but also in terms of resource utilization and costs. In developing countries, outcomes may be worse because of limited medical/surgical resources. Common sequelae include gastrointestinal (GI) tract (esophagus, stomach, pylorus, and duodenum) stricture formation, GI tract perforation, and hemorrhage. Systemic effects may also occur, such as disseminated intravascular coagulation (DIC), multi-organ system failure, and sepsis. Various interventions in the acute phase to reduce the severity of injury have been attempted, but there are no large controlled clinical trials to demonstrate efficacy. Dilation therapy in various forms is commonly used for the treatment of strictures and a variety of surgical procedures including esophagectomy and delayed replacement may be required in severe corrosive injury cases.

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Total Laparoscopic Approach for Transhiatal Esophagectomy and Gavriliu's Esophagoplasty in Children with Caustic Esophageal Injuries

Cited by 5 publications

References 17 publications

The Potential and the Limitations of Esophageal Robotic Surgery in Children

The Potential and the Limitations of Esophageal Robotic Surgery in Children

Minimal access surgery of corrosive and thermal strictures of the foregut

Corrosive substances ingestion: a review

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