Short-segment jejunoplasty: the option treatment in the management of benign esophageal stricture.
A non-dilatable benign stricture of the esophagus is a problem for the patient and always a challenge for the surgeon. The present study is intended to provide some details of surgical technique and the physiological concept that constitutes the basis for patient selection for short-segment jejunoplasty. In this study, out of 98 patients, 91 had complex stricture of the lower, and seven of the cervical esophagus. The main cause of stenosis in 60 patients (61.2%) was gastroesophageal reflux, in 34 (34.7%) post-corrosive damage, and in three (3.0%) it was other causes. All patients were treated by three methods of jejunoplasty: group I (n=54 patients) short-segment of the jejunum; group II (n=37 pts) Roux-en-Y double tract; and group III (n=7 patients) short jejunal segment on the long vascular pedicle. Intraoperative complications occurred in 17 (17.34%) of the patients. An anastomotic leak occurred only in three (3.29%) in group I and II, and 1/98 patients (1.02%) died from mediastinitis. Follow-up of functional results for up to 36 months (average 18 months) was available in 77/97 (79.3%) hospital survivors. Fifty-seven (74%) patients are satisfied with their ability to take food, postoperative reflux was completely denied by 72 (93.5%) patients. Postvagotomy diarrhea was transient and gradually subsided over the course of the first 6 months.
Randjelovic
T
T
Department of Gastrointestinal Surgery, University Hospital Center Bezanijska Kosa, Belgrade, Serbia. rantom@ssb.co.yu
Dikic
S
S
Filipovic
B
B
Gacic
D
D
Bilanovic
D
D
Stanisavljevic
N
N
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D004940:Esophageal Stenosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007583:Jejunum / Q000503:physiopathology / Q000637:transplantation*; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome