Early Complications of Gastric Transposition Operation
RAVIT RUANGTRAKOOL, M.D., F.R.C.S.T. (Surgery), Dip. Ped. Surg. (London)*,
LEWIS SPITZ, M.D., F.R.C.S., Ph.D.**
Affiliation : * Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital. Mahidol University.
Bangkok 10700, Thailand.
** Department of Surgery, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, Uni-
versity of London, United Kingdom.
AbstractGastric transpositiOn was performed in 100 children as a definitive procedure for
oesophageal replacement between 1982 and 1997 for 69 oesophageal atresia ( 41 with distal
tracheooesophageal fistula, 20 isolated oesophageal atresia and 8 with proximal tracheooeso-
phageal fistula), 16 severe caustic stricture, 7 intractable peptic reflux stricture and 8 miscella-
neous causes. Six mortalities were recorded. Sixty-five patients had complications postopera-
tively and respiratory complication was the most common complication especially in oesopha-
geal atresia patients. Swallowing difficulty, particularly in oesophageal atresia, occurred in 21
per cent of the patients. Ten patients developed cervical leakage with spontaneous closure and
8 patients suffered from anastomosis stricture. Six jejunostomy revisions were required. Three
of five pyloromyotomy obtained inadequate gastric drainage post gastric transposition and
required the conversion to pyloroplasty. Because of the distinctive low major life-threatening
morbidity and low mortality, we concluded that gastric transposition was a safe, easy and
preferable procedure for oesophageal replacement in children.
Keywords : Adolescence, Anastomosis, Surgical, Child, Preschool, Deglutition/psysiology. Esopha-
geal Atresia/surgery, Esophageal Substitute, Esophageal Diseases/surgery, Esophagec-
tomy/methods, Complication, Follow-Up Studies, Gastric Emptying/physiology,
Human, Infant, Stomach/surgery, Survival Rate, Weight Gain
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