INTRODUCTION: Initial management of wide-gap esophageal @entity1146 and @entity1727 , especially in developing countries, often involves ligation of the @entity292 , proximal esophagostomy and a gastrostomy. The conventional gastrostomy requires an abdominal incision and has several complications. The authors present an alternative technique of 'gastrostomy' that does not require an abdominal incision. METHOD: Through a standard right thoracotomy, the @entity292 is divided and tracheal end closed. If primary @entity254 is not possible due to wide gap, the lower esophageal pouch is mobilised and brought out as a stoma on the left posterior chest wall, lateral to the paraspinal muscles in the 7th or 8th intercostal space. A feeding tube is passed through the stoma into the stomach. The thorax is closed with a drain. Proximal esophagostomy is performed in the neck. The thoracic stoma is intermittently intubated for feeding until the @entity1 is ready for gastric transposition. RESULTS: The technique was successfully used in 5 @entity1 . Feeding through the stoma could be established in 4. One @entity1 had stomal retraction and died of resultant sepsis. One @entity1 has subsequently undergone gastric transposition and one more is waiting for it. Two @entity1 died of unrelated causes before esophageal replacement could be carried out. DISCUSSION: This is an alternative technique for feeding 'gastrostomy'. We have named the procedure as " @entity1514 " because the stoma is located on the chest but functions as a gastrostomy. The advantages include avoidance of a laparotomy and its complications, easy feeding by intermittent intubation, and availability of a virgin stomach for future gastric transposition.

" @entity1514 "--a new technique for feeding gastrostomy in wide-gap esophageal atresia and XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'child'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity1727 :: ('MESH:D004937', 'Disease') :: ['tracheo-esophageal fistula'] @entity1514 :: ('MESH:D013896', 'Disease') :: ['Thoracic Gastrostomy'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistula'] @entity1146 :: ('MESH:D018633', 'Disease') :: ['atresia']
@entity1727 :: (MESH:D004937,Disease) :: ['tracheo-esophageal fistula']
