Development of a novel technique for esophageal reconstruction via oral-vestibule-enteral anastomosis.

BACKGROUND: Narrowing, trauma, tumors, and systemic diseases can cause esophageal dysfunction. Severe cases resist traditional surgery, leading to long-term gastrostomy or jejunostomy tubes, affecting patients negatively. No established surgery ensures both airway and oral function with proper speech. This article introduces the oral-vestibule-enteral anastomosis (OVEA) technique, targeting patients with compromised epiglottic closure competence and loss of cervical esophagus, where conventional methods fall short. METHODS: Technique description study evaluated in 13 patients in a single tertiary referral center in Mexico City treated with OVEA from January 1990 to July 2023. RESULTS: Of the 13 patients (69% male; mean age, 37.14 ± 12.907 years), preoperative conditions included a mean body mass index of 17.78 ± 2.66 kg/m2, 46% with previous abdominal surgeries, and 31% with a smoking history. After OVEA, complications affected 46%, primarily pneumonia (23%), abscess formations (15%), intestinal necrosis (8%), and airway fistula (8%). Reoperation was needed in 38%, addressing functionality loss, necrosis, stenosis, and jawbone remodeling. No fatalities occurred within the first 6 months after surgery; 84% had successful gastrostomy tube removal, and 8% retained a tracheostomy tube. Currently 13 patients (92%) use the OVEA as their main enteral route of feeding. CONCLUSION: The OVEA technique seems promising for cases involving esophageal loss or impaired epiglottic function, enhancing patients' quality of life by enabling oral feeding and restoring regular eating habits. Further research should focus on long-term results and identifying optimal candidates for this innovative surgical method.

Myopia in schoolchildren in a rural community in the State of Mexico, Mexico.

PURPOSE: This study sought to determine the prevalence of myopia in schoolchildren of a rural population in Mexico. METHODS: A cross-sectional study was conducted in 317 children between 6 and 12 years old. A complete refractive examination was performed, including static retinoscopy without cycloplegic agents. All procedures were conducted according to the Declaration of Helsinki. RESULTS: In total, 9.7% (95% CI: 13.07-6.52) of the examined children were myopic (spherical equivalent ≤ -0.50 D), 4.4% (95% CI: 6.66-2.14) presented astigmatism (cylinder ≤ -1.50 D), and 5.4% (95% CI: 7.89-2.91) presented hyperopia (spherical equivalent ≥ +0.50 D). CONCLUSION: Additional research is required to assess the prevalence of refractive errors in rural areas in Mexico, to analyze the associated risk factors, and to implement appropriate eye care plans for this population.