Esophageal reconstruction results in surgery of pediatric patients with complex esophageal pathology in two high level hospitals of Medellín, Colombia, 2006-2016

Introduction: complex esophagus represents a final condition that occurs secondary to diseases that require multiple procedures or esophageal replacement surgery, either because it is the only treatment or because others interventions have failed. Our objective is to describe the results of esophageal reconstruction surgery in patients with complex esophageal pathology attended in two high-level hospitals in Medellin, Colombia, between January 1- 2006 and June 31- 2016. Methods: descriptive and retrospective study with review of clinical records at Hospital Pablo Tobón Uribe (HPTU) and Hospital Universitario San Vicente Fundación (HSVF), collecting 40 patients. Results: the most frequent diagnosis was esophageal atresia, followed by esophageal burn. The main causes that led these patients to be classified as complex esophagus were persistent esophageal strictures, recurrent tracheoesophageal fistulas, esophageal fistulas and the long gap. The surgical interventions were in order of frequency: gastric replacement, closure of the fistula, colon replacement, esophagostomy and gastrostomy, resection and anastomosis and esophagoplasty. The main postoperative complications of patients undergoing esophageal reinterventions or esophageal replacement were stenosis, fistulas, surgical site infection and functional disorders.Conclusions: children with complex esophageal pathology represent a challenge for pediatric surgeons, because of the difficulty of the procedures they undergo as well as the morbidity of their diseases and surgeries they require to give continuity to their digestive tract