Transhiatal oesophagectomy for benign obstructive conditions of the oesophagus.
BACKGROUND
Transhiatal oesophagectomy is an accepted approach for the treatment of carcinoma of the oesophagus. However, experience of this technique in benign diseases is limited.


METHODS
Transhiatal oesophagectomy was done in 29 patients for benign oesophageal conditions including corrosive stricture (21), achalasia of the cardia (four), tuberculosis (one), mediastinal fibrosis (one), Crohn's disease (one) and peptic stricture (one). Dysphagia was the predominant symptom in all patients; strictures had all previously been dilated repeatedly. The stomach was used as an oesophageal substitute in 24 patients; in five with a scarred stomach due to damage by a corrosive agent, oesophagocoloplasty was performed. Resection and reconstruction were done in one stage in 25 patients; four with poor nutritional status had a two-stage procedure.


RESULTS
There was no perioperative death. Complications encountered were recurrent laryngeal nerve palsy (six patients) which was mostly transient, anastomotic leak (seven) and stenosis (eight). Postoperative function of the intrathoracic stomach was satisfactory.


CONCLUSIONS
Transhiatal oesophagectomy is a safe and satisfactory procedure for benign obstructive conditions of the oesophagus.
Gupta
N M
NM
Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Goenka
M K
MK
Behera
A
A
Bhasin
D K
DK
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000601:surgery; D017558:Elective Surgical Procedures; D004931:Esophageal Achalasia / Q000601:surgery; D004935:Esophageal Diseases / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014385:Tuberculosis, Gastrointestinal / Q000601:surgery