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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Colonic conduit for esophageal replacement: Long-term endoscopic and histopathologic changes in colonic mucosa
Journal of Pediatric Surgery, Volume 47, No. 9, Year 2012
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Description
Background: Long-term follow-up has substantiated the colon as a durable and highly acceptable esophageal substitute. Exposure of colonic conduit to gastric acid may lead to histopathologic changes in the form of chronic inflammation. Materials/Methods: Thirty children with esophageal replacement were studied from 2 to 12 years (mean, 5.20 years) postoperatively. All cases underwent upper gastrointestinal tract endoscopy to evaluate the gross appearance of colonic conduit mucosa, and punch biopsies were taken from upper and lower junctions of the conduit. All biopsies were submitted to histopathologic examination. Results: Endoscopic findings were comparable with normal regarding the gross appearance of colonic mucosa in both upper and lower junctions (25 cases/83.3%). Some abnormalities were seen including cervical anastomosis stricture (2 cases/6.7%), redundancy (3 cases/10%), mucosal ulcer in the lower residual esophagus (1 case/3.3%), and hyperemia (3 cases/10%). Pathologic changes were minimal regarding the change in position of the colon to a thoracic organ during follow-up. Most of the cases were normal (22cases/73.3%). Seven cases (23.4%) showed mild chronic nonspecific inflammation of the colonic mucosa, whereas only 1 case (3.3%) showed mildly active inflammation of colonic mucosa. Conclusion: The use of the colon for esophageal replacement showed that no significant pathologic changes affecting its function as a conduit because its mucosa showed no significant change in response to gastric acid reflux in long-term follow-up and can be further protected by an antireflux procedure. © 2012 Elsevier Inc. All rights reserved.
Authors & Co-Authors
Elshafei, Hossam
Egypt, Cairo
Ain Shams University Hospitals
Elshafei, Ehab
Egypt, Cairo
Ain Shams University Hospitals
Eldebeiky, Mohamed
Egypt, Cairo
Ain Shams University Hospitals
Hegazy, Nedal Ahmed
Egypt, Cairo
Ain Shams University Hospitals
Zaki, Ahmed Medhat
Egypt, Cairo
Ain Shams University Hospitals
Abdel-Hay, Sameh A.
Egypt, Cairo
Ain Shams University Hospitals
Statistics
Citations: 16
Authors: 6
Affiliations: 1
Identifiers
Doi:
10.1016/j.jpedsurg.2012.04.002
ISSN:
00223468
e-ISSN:
15315037
Research Areas
Maternal And Child Health
Study Design
Cohort Study