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KGMU doctors use rarely used technique to fix a rare disorder

The boy's saliva would otherwise eventually flow into the trachea, enter the lungs and cause pneumonia, which could be fatal.

Six years ago, a day-old boy was brought to Prof S N Kureel, a pediatric surgeon at Lucknow’s King George’s Medical University, with a rare birth defect – his food pipe was missing, medically known as esophageal atresia. On Wednesday, he got out of the hospital, enjoying the taste of chocolate for the first time.

The boy, whose identity was not revealed to protect privacy, needed emergency attention. His saliva would otherwise eventually flow into the trachea, enter the lungs and cause pneumonia, which could be fatal.

“The established technique to correct this defect was to primarily insert a tube in the stomach through surgery for tube feeding. The upper blind end of the food pipe is exteriorised to skin so that the saliva can come out of the body. When the child is old enough (around two years of age) an artificial segment is attached, completing the foodpipe. However, since it is not natural, it could cause a lot many problems, including cancer,” said Kureel.

The doctors decided to then use a Japanese technique to grow the food pipe. “The kimura technique was developed in 1994 in Japan and involved lengthening the esophagus using tissue engineering,” he said.

He said there were only less than 20 such successful cases in the world for a disease that affected only one in 10,000 people.

“In 2012, the first operation was conducted with provision of feeding via tube into the stomach and upper blind pouch was lengthened. In 2013, the food pipe was further lengthened through another operation using tissue engineering technology. Two other operations were later conducted in 2015 and later in 2017.”

“The final stage was performed on September 6 this year. Now, a full-length natural esophagus joins the mouth to the stomach. The patient has recovered and has started taking semi-solid and solid meals. The esophagus will grow with the patient. He was discharged on Wednesday,” Dr Kureel said.

Talking to the media, patient’s mother said that soon after his birth she realised that something was wrong with her child. “His saliva was coming out of his mouth. We were all scared. We then brought him here at the KGMU and the treatment started. After these six years now my son can consume food properly and live a normal life,” she said.

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