The History and Legacy of the Foker Process for the Treatment of Long Gap Esophageal Atresia.

Historically, children afflicted with long gap esophageal atresia (LGEA) had few options, either esophageal replacement or a life of gastrostomy feeds. In 1997, John Foker from Minnesota revolutionized the treatment of LGEA. His new procedure focused on "traction-induced growth" when the proximal and distal esophageal segments were too far apart for primary repair. Foker's approach involved placement of pledgeted sutures on both esophageal pouches connected to an externalized traction system which could be serially tightened, allowing for tension-induced esophageal growth and a delayed primary repair. Despite its potential, the Foker process was received with criticism and disbelief, and to this day, controversy remains regarding its mechanism of action - esophageal growth versus stretch. Nonetheless, early adopters such as Rusty Jennings of Boston embraced Foker's central principle that "one's own esophagus is best" and was instrumental to the implementation and rise in popularity of the Foker process. The downstream effects of this emphasis on esophageal preservation would uncover the need for a focused yet multidisciplinary approach to the many challenges that EA children face beyond "just the esophagus", leading to the first Esophageal and Airway Treatment Center for children. Consequently, the development of new techniques for the multidimensional care of the LGEA child evolved such as the posterior tracheopexy for associated tracheomalacia, the supercharged jejunal interposition, as well as minimally invasive internalized esophageal traction systems. We recognize the work of Foker and Jennings as key catalysts of an era of esophageal preservation and multidisciplinary care of children with EA.

Esophagoplasty using previously resected stomach proposed by A.A. Rusanov: history and the current state.

To perform esophageal reconstruction in patients after distal gastrectomy colonic or jejunal transplant is usually used. But the use of remnant stomach in esophagoplasty appears to be an interesting idea. This method preserves some advantages of esophagogastroplasty as such. It is possible to pull-up the remnant stomach to the needed level, using mobilization with the spleen and pancreatic tail and its transposition into the left pleural cavity. This type of esophageal replacement, currently widely adopted in China, was proposed and first performed in 1958 by Professor A.A. Rusanov from Russia (former USSR). Different aspects of this method including historical are discussed in the literature review.

The development of cardiac surgery in West Africa--the case of Ghana.

West Africa is one of the poorest regions of the world. The sixteen nations listed by the United Nations in this sub-region have some of the lowest gross domestic products in the world. Health care infrastructure is deficient in most of these countries. Cardiac surgery, with its heavy financial outlay is unavailable in many West African countries. These facts notwithstanding, some West African countries have a proud history of open heart surgery not very well known even in African health care circles. Many African health care givers are under the erroneous impression that the cardiovascular surgical landscape of West Africa is blank. However, documented reports of open-heart surgery in Ghana dates as far back as 1964 when surface cooling was used by Ghanaian surgeons to close atrial septal defects. Ghana's National Cardiothoracic Center is still very active and is accredited by the West African College of Surgeons for the training of cardiothoracic surgeons. Reports from Nigeria indicate open-heart surgery taking place from 1974. Cote D'Ivoire had reported on its first 300 open-heart cases by 1983. Senegal reported open-heart surgery from 1995 and still runs an active center. Cameroon started out in 2009 with work done by an Italian group that ultimately aims to train indigenous surgeons to run the program. This review traces the development and current state of cardiothoracic surgery in West Africa with Ghana's National Cardiothoracic Center as the reference. It aims to dispel the notion that there are no major active cardiothoracic centers in the West African sub-region.

[History of surgical esophageal replacement]. / Geschichte des operativen Oesophagusersatzes.

At the beginning of the twentieth century, surgeons often attempted operative esophagus replacement. At first, these operations had a palliative intent to help the patients eat. Setbacks because of lack of experience in thorax surgery, infection problems and technical difficulties led to different approaches to a solution. The first successes occurred when a stomach tube was formed with a abdominocollar high course and collar anastomosis. The history of surgical replacement of the esophagus is given in detail to the present day and the development is discussed.

[Contribution of B.A. Petrov to development of methods for surgical treatment of postburn esophageal strictures]. / Vklad B.A Petrova v razrabotku metodov khirurgicheskogo lecheniia posleozhogovykh striktur pishzhevoda.

The article in historical aspect presents more than 40-year experience in improvement of methods for surgical treatment of esophagus and stomach burn aftereffects in N.V. Sklifossovsky Research Institute of Emergency Care. Great role in development of this problem of B.A. Petrov is stressed, who, as a follower of S.S. Yudin, has perfected a method of intestinal plastics, developed and applied in practice a technique of retrosternal esophagoplasty from ileocolon and has laid the foundation of reconstructive surgery on an artificial esophagus. The authors autline their own experience of the last two decades: 158 total isoperistaltic retrosternal esophagoplasties from the colon with lethality 3.1%. To present cancer, in 115 patients cicatricised esophagus was removed, lethality being 2.6%. Attention was paid to the physiological aspects of esophagoplasty, especially in the light of long-term results.

The history of esophageal surgery: pediatric aspects.

An attempt is made to explore those aspects of the history of esophageal surgery relevant to pediatric practice. In some areas, the history is entirely focused on conditions of particular pediatric significance; esophageal atresia is a classic example of this group. In other areas there is considerable overlap, which varies in extent, with the history of esophageal surgery in adult. Conditions to be considered in this group include gastroesophageal reflux and peptic and corrosive esophagitis. Finally, there is a group that for all practical purposes is related to patients in the adult age group, exemplified by carcinoma of the esophagus, but some aspects of the history of surgery for esophageal cancer are relevant to pediatric practice, particularly in the area of reconstruction of the alimentary tract and esophageal replacement. Before the consideration of each of these groups, comments are directed toward the "early days"" or the beginnings.

[Development of reconstruction surgery of pharynx and esophagus]. / Rozwój chirurgii rekonstrukcyjnej gardla i przelyku.

We present historical review of pharyngooesophageal reconstruction after resection for carcinoma and pharynx and oesophagus stenosis. This paper presents development and complications after surgical treatment of pharynx and oesophagus. The most important of pharynx and oesophagus resection is reconstructive surgery.

The Nissen fundoplication.

The most commonly employed antireflux operation is the Nissen fundoplication. However, its origin and subsequent modifications are rarely defined. These aspects of the operation are reviewed in this article as are the results currently obtainable with the modern version of the operative procedure.

[Role and significance of S. S. Iudin in the development of reconstructive surgery of the esophagus]. / Rol' i znachenie S. S. Iudina v razvitii rekonstruktivnoi khirurgii pishchevoda.

Merits can be conferred upon S. S. Yudin not only in the improvement of the method of esophagoplasty with the small intestine suggested by C. Roux in 1907, but also in the development of reconstructive surgery of the esophagus on the whole. Although new methods for esophagoplasty have been suggested and new technical possibilities have appeared, many elements of surgical tactics, operative techniques, and instruments suggested by S. S. Yudin are still applied in reconstructive surgery of the esophagus. Among them are the detailed description of jejunal architectonics from the surgeon's point of view, the wide use of test compression of the mesenteric vessels to evaluate the adequacy of blood supply to the graft, description of the clinical signs of disturbed blood supply to the graft, etc. S. S. Yudin laid the foundations of scientific research into the morphological and functional reorganization of organs and tissues in prolonged existence under unusual conditions, which is of great theoretical importance. Twenty-year experience in reconstructive surgery of the esophagus allow the author of this article to appraise at their true worth the technical procedures and physiological approaches suggested by S. S. Yudin, which are being developed further under modern conditions. This applies to substantiation of the most reliable and physiological method of retrosternal esophagoplasty with the colon with isoperistaltic position of the graft, transpleural resection of a cicatricially deformed esophagus, surgical treatment of achalasia of the superior esophageal sphincter.

The surgical management of esophageal stricture in children. A century of progress.

Early in this century all procedures performed on the esophagus were accomplished through its lumen. Ingestion of caustics was common and resulted in dense strictures for which complicated and ingenious methods of dilation were advised. Because obstructions usually recurred, by-pass operations were devised with conduits of skin or segments of the gastrointestinal tract. Now, in contrast, when burns occur, intensive steroid therapy usually prevents all but localized areas of stricture. These areas, if short, can be treated with hydrostatic balloon dilation under fluoroscopic control. If longer or resistant to dilation, these strictures can be managed by incision and insertion of a colic patch with excellent long-term results. To a previous series of children who have had esophageal patch with a vascularized segment of colon, now added is an experience with a free segment of small intestine with vascular anastomosis to an artery and vein in the neck and another case of a free patch of pericardium to the esophageal stricture.