RT Book, Section
A1 Hendren, W. Hardy
A1 Weldon, Christopher B.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Colson, Yolonda L.
A2 Jaklitsch, Michael T.
A2 Krasna, Mark J.
A2 Mentzer, Steven J.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1105840938
T1 Congenital Disorders of the Esophagus in Infants and Children
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105840938
RD 2024/04/19
AB This  chapter  presents  the  most  common  congenital  malformations  of  the  esophagus  that  require  surgical  correction  in  infants  and  children.  Today,  most  of  these  entities  can  be  corrected,  and  a  child  can  lead  a  normal  life  after  surgery.  That  was  not  true  until  1939,  when  Logan  Leven  of  Minneapolis1  and  William  E.  Ladd  of  Boston2  independently  saved  a  newborn  with  esophageal  atresia  on  the  same  date!  The  operation  consisted  of  dividing  the  tracheoesophageal  fistula  (TEF),  marsupializing  the  blindly  ending  upper  esophageal  pouch,  and  feeding  the  baby  temporarily  through  a  gastrostomy.  Later,  a  multistaged  reconstruction  was  performed  to  make  an  antethoracic  esophageal  substitute,  which  was  placed  subcutaneously  anterior  to  the  sternum.  The  lower  two-thirds  of  this  conduit  consisted  of  a  Roux-en-Y  loop  of  upper  jejunum  that  bypassed  the  stomach  and  duodenum.  The  upper  third  of  the  conduit  was  a  tubularized  full-thickness  graft  comprised  of  skin  and  subcutaneous  tissue.  This  was  used  to  bridge  the  gap  between  the  upper  esophageal  segment,  which  had  been  marsupialized  in  the  neck,  and  the  Roux-en-Y  loop,  which  was  brought  up  to  the  level  of  the  upper  sternum.