[Esophago-jejuno-gastroplasty in the treatment of peptic stenosis of the esophagus].
From 1973 to 1994, 21 patients with esophageal peptic stenosis were submitted to esophago-jejuno-gastroplasty with Merendino's technique. In 14 cases peptic stenosis developed after Heller's myotomy for achalasia, associated in 3 cases with fundoplication. In 3 patients the stenosis was secondary to fundoplication. Other 3 subjects presented a primary stenosis. One patient showed Barrett's esophagus with in situ carcinoma. Endoscopic esophageal dilatation was attempted in every patient with no satisfactory results. One patient died for a postoperative cardiopulmonary failure (4.7%). One patient developed a fistula of the esophago-jejunal anastomosis treated with enteral nutrition successfully (4.7%). In another subject splenectomy was performed following a iatrogenic injury (4.7%). Minor complications developed in 5 patients (23.7%). After one year from operation in 1 patient a severe stricture of esophago-jejunal anastomosis appeared; it was treated with anastomotic resection and reconstruction. After 8 years one patient was submitted to a partial resection of interposed jejunal loop, that was redundant. In 18 patients long term follow-up showed good results in 14 patients (78%), discrete in 2 (11%), unsatisfactory in 2 (11%). Our results show that Merendino's esophago-jejunal gastroplasty allows to achieve good results with acceptable rate of mortality and morbidity.
Della Casa
U
U
Università degli Studi di Roma La Sapienza, Istituto di I Clinica Chirurgica.
Picchio
M
M
Passaro
U
U
Lombardi
A
A
Ramacciato
G
G
Amodio
P M
PM
Paolini
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004942:Esophagitis, Peptic / Q000150:complications*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013270:Stomach / Q000601:surgery*; D013997:Time Factors