Antireflux plastic repair of the cologastric anastomosis in a female patient operated on by retrosternal esophagocoloplasty

Esophageal atresia without fistula is a rather uncommon malformation (about 8% of all esophageal atresias); its surgical correction is sometimes difficult because of the long gap between the two pouches. When a delayed anastomosis cannot be performed, it is necessary to perform a colon interposition. In one patient operated with retrosternal esophageal-colon-plasty a second operation was needed to correct a symptomatic reflux causing dysphasia and severe aspiration pneumonia. The distal end of the colon was tapered around a chest tube; then a submucosal gastric tunnel was prepared, and the tapered colon was pulled through it and anastomosed to the gastric lumen. The child showed no evidence of gastrocolic reflux in the three years following the operation and is today healthy. Radiologic and scintigraphic examinations, performed ten months after the operation, showed the good canalization of the interposed colon and the continence of the antireflux anastomosis.