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Oral Presentation - 4
What happens with Collis-Nissen surgery in children in the long term?
Carlos Garcia-Hernandez, Lourdes Carvajal-Figueroa, Ariadna Alvelais-Arzamendi, Carlos Aguilar-Gutierrez
Universidad Nacional Autónoma de México
Introduction: Collis-Nissen surgery is an alternative for the treatment of short esophagus. There is evidence of good short-term results, but it is unknown what happens in children in the long term. In adult patients, serious complications such as peptic ulcers and necrosis are reported. The objective is to determine the outcome of children undergoing the minimally invasive Collis-Nissen procedure more than five years after surgery.
Methods: Patients were included more than 5 years after surgery. Clinical follow-up included reflux symptoms, stricture recurrence, and medication use. Radiological and endoscopic follow-up was performed at 1 and 5 years. This study was approved by the hospital's research committee
Results: From 2005 to 2024, 12 patients were included, with more than 5 years of surgery. Ages ranged from 9 to 20 years; 7 men and 5 women. Currently, 9 children are asymptomatic; two reports occasional pain and the other occasional dysphagia. Contrast showed the same caliber as the native esophagus as the neoesophagus, adequate clearance, and infradiaphragmatic fundoplication. Endoscopy showed a normal appearance of the native esophagus and neoesophagus. The Z line was located 6-8 cm above the diaphragmatic clamping, the cardia was continent, and the fundoplication was efficient in retrospect. Histopathological examination of the native esophagus reported mild esophagitis, and the neoesophagus had mucin-producing epithelium, no metaplasia, and a 10:1 ratio of foveolar cells (which produce mucus) to oxyntic cells (which produce acid).
Conclusion: The laparoscopic Collis-Nissen procedure is effective in the long-term treatment of short esophagus in children. The absence of peptic ulcers is due to the proportion of mucus-producing cells in the portion used to create the Collis-Nissen procedure. The good outcome of our patients is likely because we did not use an acid-producing portion of the stomach.