Colonic esophagopharyngoplasty in combined chemical esophageal and pharyngeal strictures.
The treatment of patients with combined chemical strictures located in the upper gastrointestinal tract presents a difficult task. A complicated mechanism of swallowing-breathing can be broken by the development of a cicatricial process in the pharynx or laryngo-oropharynx. The surgical interference is aimed not only at construction of an artificial esophagus but restoration of the normal swallowing and adequate feeding of a patient. The article presents the experience of 47 colonic esophagopharyngoplasties. Preference is given to one-stage procedures. The graft in the majority of cases was constructed from the left colon. The mortality rate was 2.1%, and pharyngeal anastomotic leak occurred in 5 (10.6%) patients. Pharyngeal anastomotic cicatricial stricture developed in 4 (8.5%) patients and 2 of them required of reconstructive surgery. Long-term results have shown that the majority of patients are using the artificial esophagus. Only in 2 patients is swallowing still impaired and they continue to feed via a gastrostomy. The results obtained show that a one-stage colonic esophagopharyngoplasty is the method of choice in combined chemical pharyngoesophageal strictures. Nevertheless, such procedures should only be carried out in specialized divisions with experience in reconstructive esophageal surgery.
Department of Surgical Gastroenterology, The Research Centre of Surgery, Russian Academy of Medical Sciences, Moscow.
A F
AF
Chernousov
V A
VA
Andrijanov
P M
PM
Bogopolsky
M E
ME
Voronov
V V
VV
Titov
D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000601:surgery; D003106:Colon / Q000637:transplantation*; D003251:Constriction, Pathologic / Q000601:surgery; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000601:surgery*; D004944:Esophagoplasty / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000139:chemically induced / Q000473:pathology / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications