[Pharyngo-esophagoplasty by right coloplasty for the treatment of post-caustic pharyngo-laryngeal-esophageal burns: a report of 13 cases].
We report a new technique of pharyngoesophagoplasty by right coloplasty, indicated in postcaustic severe pharyngeal stenosis, analyzing the anatomical and functional results in terms of respiratory tract and phonation as well as digestive tract outcome. We compared our results with those obtained with other procedures. Between March 1995 and September 1998, pharyngoesophagoplasty by right coloplasty was performed in 13 patients. All had severe hypopharyngeal stricture with total obliteration of the two piriform sinuses and the upper esophageal sphincter. Nine patients underwent emergency esophagectomy or esogastrectomy by stripping and four had a cicatricial esophagus. Eight patients underwent tracheotomy before the pharyngoplasty due to burns of the laryngeal margin or airway infections. There was no perioperative mortality. The retrospective analysis in February 1998 with a follow-up of 22 months disclosed two deaths, one from septic shock following pneumnia and one suicide. For the 11 other patients, respiratory function had been restored successfully as the tracheostomy tube had been removed. Eight of the patients were on regular oral diet and the jejunostomy tube had been removed. Three had mild dysphagia and the oral diet was supplemented by jejunostomy tube feedings. These results were most successful compared with those obtained with 29 other patients. Pharyngo-esophagoplasty by right colonic transposition appears to be the method of choice for the reconstruction of post-caustic pharyngeal and esophageal stenosis.
Brette
M
M
Service d'ORL et chirurgie maxillo-faciale, Hôpital Saint Louis, 1, avenue Claude Vellefaux, 75010 Paris.
Aidan
K
K
Halimi
B
B
Cattan
P
P
Grozier
F
F
Sarfati
E
E
Monteil
J
J
D000328:Adult; D002057:Burns, Chemical / Q000209:etiology* / Q000601:surgery*; D002424:Caustics / Q000009:adverse effects*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010614:Pharynx / Q000601:surgery*; D016896:Treatment Outcome
D002424:Caustics
La pharyngo-oesophagoplastie par transplant colique droit dans le traitement des séquelles de brûlures caustiques pharyngo-laryngo-oesophagiennes: à propos de 13 cas.