Esophageal reconstruction after caustic injury: is there still a place for right coloplasty?
BACKGROUND
Through a systematic policy of using the right colon as an esophageal substitute, the authors analyze the reliability of this transplant for reconstruction after digestive caustic injury.


METHODS
From 1995 to 2005, a right coloplasty was attempted in 81 patients after total esophagogastrectomy (n = 57) or for esophageal stricture (n = 24).


RESULTS
The use of the right colon was not possible in 10 patients (12%) because of insufficient blood supply. In addition, postoperative right colic graft necrosis occurred in 5 patients. Cervical fistula occurred in 25 patients (31%). Opening of the thoracic inlet was associated with a lower rate of this complication (P = .04). At the end of the follow-up, 71 patients (88%) recovered oral feeding.


CONCLUSIONS
Attempt to use the right colon as an esophageal substitute failed in 18% of the patients. Despite high rates of cervical complications, in part linked to the peculiar setting of caustic injury, functional results remains satisfactory.
Bothereau
Hervé
H
Department of Digestive and Endocrine Surgery, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75010, Paris, France.
Munoz-Bongrand
Nicolas
N
Lambert
Benoît
B
Montemagno
Sébastino
S
Cattan
Pierre
P
Sarfati
Emile
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D002057:Burns, Chemical / Q000150:complications* / Q000601:surgery; D002424:Caustics / Q000009:adverse effects*; D003106:Colon / Q000637:transplantation*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
D002424:Caustics