Laparoscopic gastric transposition with cervical esophagogastric anastomosis as esophageal replacement in pediatric patients: 10-year experience from 2 Colombian medical centers

Gastric pull-up has been described as an alternative for esophageal replacement in patients with congenital or acquired conditions, allowing restoration of gastrointestinal tract continuity and function. In our surgical team, the minimally invasive approach has become the preferred technique. In this article, we present our 10-year experience with this procedure. We conducted a retrospective study of patients who underwent laparoscopic gastric transposition with cervical esophagogastric anastomosis as esophageal replacement at two referral medical centers in Cali, Colombia, between January 2015 and December 2024. A total of 13 patients were identified, most of them female (53.8%). The mean age was 8.4 years (range: 6 months–19 years). The main indications for esophageal replacement were caustic injury (61.5%), esophageal atresia (30.8%), and one case of systemic scleroderma. The majority (92.3%) were performed via the posterior mediastinal route, and 48.2% included pyloroplasty. Only one conversion to open surgery was required due to adhesions at the site of a previous esophageal stent. Anastomotic stricture occurred in 23% of cases; one required resection and re-anastomosis, while the others were successfully managed endoscopically. One case of anastomotic leak was treated with endoluminal vacuum-assisted closure therapy without the need for reoperation. At follow-up, all patients were feeding orally, achieving 100% of their nutritional requirements. Laparoscopic gastric pull-up is a safe and effective alternative for esophageal replacement in pediatric patients. This technique minimizes cardiopulmonary compromise, requires only a single cervical anastomosis, and is associated with favorable long-term outcomes and high levels of parental and patient satisfaction.