Lucknow: Docs perform rare surgery to treat child born with incomplete food pipe

Hindustan Times, Lucknow | ByGaurav Saigal, Lucknow

Sep 27, 2018 12:36 PM IST

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A six-year-old child born with esophageal atresia, a rare birth defect in which a baby is born without a part of the tube that connects the mouth to stomach (esophagus), became the first Indian child to be operated by Kimura technique.

A six-year-old child born with esophageal atresia, a rare birth defect in which a baby is born without a part of the tube that connects the mouth to stomach (esophagus), became the first Indian child to be operated by Kimura technique.

The child who had been living only on milk was seen eating chocolate at the King George’s Medical University in Lucknow.(Representative image)

The child who had been living only on milk was seen eating chocolate at the King George’s Medical University (KGMU) on Wednesday afternoon.

What is tissue engineering?

Esophagus has four layers – submucosa, mucosa, muscle and fascia.

In 1994, M Kimura of Japan gave the idea that if the fascia layer of the esophagus is dissected without disturbing the muscle, esophagus can grow in length and by repeating this, the length can grow equal to the gap in the body.

Prof Kureel did the same and, in four attempts, got the length of the esophagus increased to match the gap in the esophagus. He repeatedly made cuts and allowed the esophagus to grow.

“The technique also demands that the food pipe made should be put under the heart chamber. This was done in the last operation,” said Dr Archika Gupta, who was a part of the team which conducted the surgery.

Head of paediatric surgery department at KGMU Prof SN Kureel said: “This is the first Indian child to be operated upon for the rare disease with Kimura technique. He can now have a normal life.

Conventionally, a different method is used to treat the rare disease but it has its own drawback.

Two pipes are inserted in the body near the chest and stomach. The first pipe near the chest helps in draining out saliva from the mouth while the other is used to feed the child. This continues for 3-4 years after which the surgeons conduct an operation and make an artificial food pipe by extracting a portion of stomach or colon from the child’s body.

Prof Kureel applied tissue engineering and helped original esophagus to grow naturally. This was done by cutting the upper most layer of the esophagus and allowing it to regenerate in length.

The doctors did this procedure for four times in 2012 hours after the child birth then again in 2013, 2015 and 2017.

In each operation, the length increased by over a centimetre and now it will grow naturally with age.

“It required high precision and we are happy to share that the final procedure of joining the stomach with the fully grown food pipe was done on September 6. Now, whatever the child eats goes into the stomach without any pipe,” said Prof Kureel.

It was a big relief for the child’s mother too.

“We were worried when the doctors told us that the food pipe was not complete. He had been living only on milk we fed from the pipe. Today we are happy to see our child eating like other children of his age,” she said.