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A new method of retrosternal tunnel formation during esophagoplasty in children

[Surgery]
Gennady Chepurnoy; Andrey Kivva; Mikhail Chepurnoy; Kirill Novikov; Marina Kaimakchi;

Based on studies of the sternum and muscles covering it, a topographic-anatomically sound method was developed for forming a retrosternal tunnel in children with esophagoplasty, which prevents compression of the graft in the retrosternal space. A new technique was applied in 27 young children with atresia (13) and cicatricial strictures (14) of the esophagus. Using ultrasound, we determined the angle (α) between the posterior surfaces of the manubrium of sternum and its body in a child. At α<165 °, the manubrium of sternum was cut off at the level of the second rib, and at α≥165 ° – at the level of the first rib, keeping muscle attachment points and areas with a significant content of red bone marrow. All patients after surgery showed good bolus patency through the artificial esophagus. The proposed technique provides good results of treatment, preventing the possibility of retrosternal compression of the graft.

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References:
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Keywords: esophagoplasty, retrosternal tunnel, children


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