Results of gastric pull-up procedure in neonatal long-gap esophageal atresia: a single center prospective study

Background: The management of long-gap esophageal atresia (LGEA) remains challenging and esophageal replacement is necessary in a number of cases, with the conduit of choice for potential surgical expertise. The current study aimed at assessing the outcomes of gastric pull-up surgery for esophageal reconstruction in children with LGEA, and investigating the postoperative results, complications, and mortality. Materials and Methods: Sixteen patients with LGEA were studied at Tabriz Children’s Hospital, Tabriz, Iran. Gastric pull-up technique was used for esophageal replacement in all the patients. The study duration was 23 months from April 2014 to March 2016. Results: The mean age of the patients was 7.31 ± 3.91 days. Eleven patients (68.75%) were male and five (31.25%) female. Seven patients (43.75%)  had esophageal atresia type A and nine patients (56.25%) had the type C. All patients (100%) were in need for postoperative mechanical ventilation. Mean period of postoperative mechanical ventilation was5.69 ± 0.87  days. Postoperative mortality was observed in three patients (18.75%). Patients were followed up for six months after the operation; poor feeding was observed in four patients(30.77%) , mild respiratory distress in three patients (23.08%), and choking and aspiration in three patients  (%23.08). Conclusion: It was observed that gastric pull-up technique was a feasible and safe surgical method for patients with long-gap esophageal atresia when primary anastomosis was not possible. Quality of life, feeding, and growth pattern were also acceptable. However, long-term outcomes were not assessed in the current study.