Eur J Pediatr Surg 2011; 21(3): 178-182
DOI: 10.1055/s-0031-1271710
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Modified Spitz Procedure Using a Collis Gastroplasty for the Repair of Long-Gap Esophageal Atresia

A. Schneider1 , C. G. Ferreira1 , I. Kauffmann1 , I. Lacreuse1 , F. Becmeur1
  • 1University Hospital of Strasbourg, Department of Pediatric Surgery, Strasbourg, France
Further Information

Publication History

received November 24, 2010

accepted after revision January 05, 2011

Publication Date:
14 March 2011 (online)


Objective: We report here on our experience with a modified Spitz procedure using a Collis gastroplasty for the repair of long-gap esophageal atresia (EA).

Patients and Methods: The authors reviewed 5 cases of children with long-gap (5–6 vertebral bodies) EA. The repair was carried out after 3 months of permanent monitoring, enteral nutrition through a gastrostomy tube and permanent aspiration of the proximal esophagus. The Collis gastroplasty was performed to create a gastric tube along the gastric lesser curvature using an Endo-GIA linear stapler. The gastric tube can be easily mobilized into the thorax after ligation of the left gastric vessels and anastomosed to the proximal esophageal segment.

Results: There were no intraoperative complications. The median postoperative hospital stay was 39 days (range: 30–60) with a median follow-up of 20 months (range: 16–29). During the early follow-up period, a digestive occlusion occurred in one patient, and several months later, she suffered from hiatal herniation. Other postoperative complications included anastomotic stricture (n=2) treated by dilatations, gastroesophageal reflux (GER) (n=3), and weight delay (n=3) requiring additional enteral nutrition in 2 cases. No mortality was seen in our series.

Conclusions: We propose a modified Spitz procedure using a Collis gastroplasty in the primary repair of long-gap EA as an alternative option to esophageal replacement or elongation techniques. The complications noted in our series are common complications of EA surgical repair, such as GER, anastomotic stricture and ponderal stagnation.


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