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Oesophageal replacement in paediatric patients.

Over a 5-year period from January 1986 to December 1990, 24 children aged between 16 months and 12 years with undilatable oesophageal stricture had oesophageal replacement with isoperistaltic colonic conduit. All the strictures followed accidental corrosive burns. The procedure was well tolerated; all the patients were able to swallow within 3 weeks of surgery. Major postoperative complications were threatening pneumothorax (two cases), gastric outlet obstruction due to Ascaris lumbricoides (two cases) and cervical fistula (eight cases) which closed spontaneously in each case. There were no operative or postoperative deaths. Twenty-two patients have been followed up for 2-59 months. Children tolerate oesophageal replacement well. The short-term and medium-term results are good, but anxiety over the fate of the retained native oesophagus is noted.