Application and efficacy of total gastric transposition in long gap of esophageal atresia

Objective To explore the application and efficacy of total gastric transposition in long gap of esophageal atresia (＞3cm) in children.Methods From March 2005 to October 2010,7 cases of patients with long gap esophageal atresia underwent total gastric transposition in our centre,which included 5 males and 2 females with average 36 hours old (ranging from 2 to 96 hours).Their birth weight ranged from 1800 to 3 500 grams.The diagnosis was made based on the chest-abdominal radiograph,they were 2 cases of type Ⅰ and 5 cases of type Ⅲa.Results All procedures were completed and average operating time was 180 minutes (ranging from 150 to 200 minutes).1case died and 1case refused further treatment after operation,1case underwent drainage and nutrition supporting due to postoperative anastomotic leak,and healed which was confirmed by radiograph investigation.The follow-up time ranged from 1to 5 years,in 5 patients dilating procedures were done in 2 cases due to anastomotic stricture and GERD could be seen in all patients.4 cases had a normal height and weight,1case complaining dyspnoea had a lower weight and height.Conclusions Total gastric transposition is effective approach for long gap of esophageal atresia,some advantages can been presented involving improvement of survival for patients after treatment and reduced incidence of anastomotic stricture.Meanwhile,the occurring of GERD and Baeert's esophagus still catch the attention by surgeons. Key words: Esophageal atresia;  Long gap;  Esophageal reconstruction;  Complication