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335335

Vascular anatomical considerations in preparing colonic flaps to replace the oesophagus

Article

Last updated: 05 Jan 2025

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Abstract

Background
The colon is among the best options to substitute the oesophagus; it is well known for its durability and good function that makes it most suitable for paediatric patients. The steps of the procedure, postoperative complications, and outcome assessment were thoroughly discussed in previous reports. However, in this report, we have tried to focus on one basic and essential step of the operation, which is fashioning of the colonic flap used to substitute the oesophagus.
Results
The study included 50 consecutive paediatric cases who underwent colonic replacement of the oesophagus during the period 2010 through 2020. The indication for oesophageal replacement was either oesophageal atresia (27 cases) or corrosive strictures (23 cases). Our standard technique was using a middle segment of the colon (transverse colon) based on the left colic vessels (vascular pedicle) after ligation of middle colic vessels. Variations of the middle colic vessels were encountered that included single, double, or absent vessels. In a single case (2%), the middle colic vessels were multiple, short, and non-branching with interrupted continuity of marginal vessels at that point. In the latter situation, we had to use a different technique by fashioning a right colonic flap based on the middle colic vessels.
Conclusion
In colonic replacement of the oesophagus, preparing a pedicled flap from the transverse colon based on the left colic vessels was almost always feasible owing to the stable collateral marginal vessels. On a rare occasion, the marginal vessels were interrupted by disturbed anatomy of the middle colic vessels when we had to shift to another technique using a right colonic flap.

DOI

10.1186/s43159-021-00119-2

Keywords

Oesophageal substitution, Oesophageal atresia, Caustic strictures, Colon bypass, Anti-reflux

Authors

First Name

Amr

Last Name

AbouZeid

MiddleName

Abdelhamid

Affiliation

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Email

amrabdelhamid@hotmail.com

City

-

Orcid

0000-0003-2681-6086

Volume

17

Article Issue

1

Related Issue

45423

Issue Date

2021-02-01

Receive Date

2021-07-12

Publish Date

2021-10-04

Print ISSN

1687-4137

Online ISSN

2090-5394

Link

https://apsj.journals.ekb.eg/article_335335.html

Detail API

https://apsj.journals.ekb.eg/service?article_code=335335

Order

335,335

Publication Type

Journal

Publication Title

Annals of Pediatric Surgery

Publication Link

https://apsj.journals.ekb.eg/

MainTitle

Vascular anatomical considerations in preparing colonic flaps to replace the oesophagus

Details

Type

Article

Created At

20 Dec 2024