Cervical Esophagostomy

CHAPTER 6 Cervical Esophagostomy



Richard Ricketts



Step 1: Surgical Anatomy



♦ The approach is usually through the left side.

♦ Note the relationship of the trachea, esophagus, recurrent laryngeal nerve, and the thoracic duct (Fig. 6-1).

image

Figure 6-1



Step 2: Preoperative Considerations



♦ Use the left side of the neck for future esophageal replacement because this procedure will be done through the left chest, the mediastinum, or in the substernal position.

♦ Use the right side of the neck for the Kimura esophageal lengthening procedure (Kimura and Soper, 1994).

♦ Preoperative prophylactic antibiotics should be given.


Step 3: Operative Steps



Anesthetic Induction



♦ Endotracheal intubation and relaxation are used.

♦ The anesthesiologist should pass a blunt tipped bougie down the esophagus; this will aid in identifying the esophagus.


Positioning



♦ Place the patient supine with a roll under the shoulders to extend the neck.

♦ Turn the head slightly to the contralateral (usually right) side.


Incision


Related posts:

  1. Thyroglossal Duct Cyst
  2. Congenital Diaphragmatic Hernia and Eventration of the Diaphragm
  3. Laparoscopic and Open Pyloromyotomy
  4. Biliary Atresia

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Jun 18, 2016 | Posted by in PEDIATRICS | Comments Off on Cervical Esophagostomy

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