Users Online : 550 About us |  Subscribe |  e-Alerts  | Feedback | Login   |   
Journal of Minimal Access Surgery Current Issue | Archives | Ahead Of Print Journal of Minimal Access Surgery
           Print this page Email this page   Small font sizeDefault font sizeIncrease font size 
 
HOW I DO IT
Ahead of Print

Thoracoscopic oesophago-oesophagostomy in the prone position for oesophageal stenosis caused by dilated azygos vein in polysplenia-associated heterotaxy


 Department of Surgical Gastroenterology and Minimal Invasive Surgery, Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital Cum Medical Research Center, Jaipur, Rajasthan, India

Correspondence Address:
Rajesh Bhojwani,
Department of Surgical Gastroenterology and Minimal Invasive Surgery, Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital Cum Medical Research Center, Jaipur, Rajasthan
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_313_20

PMID: 33605935

Background: Heterotaxy syndrome is associated with a plethora of cardiovascular and other multi-system anomalies with a high childhood mortality. A dilated azygos vein as part of the polysplenia variant of heterotaxy syndrome may cause oesophageal stenosis owing to a prolonged compression. We describe our technique of extramediastinal oesophago-oesophagostomy in the prone position for this rare congenital syndromic malformation with an excellent outcome. Patients and Methods: A 17-year-old boy with heterotaxy syndrome presented with intermittent dysphagia and postprandial emesis with failure to thrive. Despite the presence of diverse anatomic abnormalities, it was only his symptom of dysphagia due to oesophageal stricture that merited surgical intervention. He underwent an azygos-preserving extramediastinal oesophago-oesophagostomy in the prone position without segmental resection with the establishment of continuity using a modified Collard-type anastomosis. Results: The patient had an uneventful convalescence, with imaging after 1 year showing no re-stenosis. After a follow-up of 3 years, the patient is free of symptoms and has gained weight. Conclusion: Oesophageal stenosis may result from prolonged compression by anomalous vasculature. An isolated correctable anatomic derangement, young age with good functional reserve, other associated anomalies not causing any symptoms, the physiological advantages of executing the surgery in a prone position and availability of expertise in minimally invasive surgery ensured excellent outcomes. The hitherto unreported technique may open up avenues for further research regarding the behaviour of the oesophageal muscular tube with transection and re-anastomosis for rare benign abnormalities.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Bhojwani R
    -  Jain N
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed764    
    PDF Downloaded24    

Recommend this journal

2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04