[Second time esophageal reconstruction surgery: coloplasty and gastroplasty].
OBJECTIVE
To analyze the morbidity and mortality of second time esophageal reconstruction in an Esophagogastric Unit.


METHODS
Second time esophageal reconstruction surgery with coloplasty and gastroplasty was performed on 20 patients, from January 2001 to October 2006. The morbidity and mortality of each technique has been analyzed retrospectively.


RESULTS
The mean age of the 16 males and 4 women operated on was 54.3 +/- 17.5 years. The diagnoses at the first surgery were: 7 caustic ingestions, 7 Boerhaave syndrome, 3 iatrogenic perforations, 1 tracheal-esophageal fistula, 1 esophageal-jejunal dehiscence and 1 necrosis of the gastroplasty after transhiatal oesophagectomy. There were 14 (70%) right coloplasties, 4 (20%) left coloplasties and 2 (10%) gastroplasties with gastric conditioning. In 11 of the 20 patients gastroplasty was ruled out due to gastrectomy (8 cases) or previous gastric surgery (3 cases). It was noted on analyzing the morbidity: pleural effusion (65%), respiratory failure (45%), atelectasis (35%) and cervical anastomosis dehiscence (35%). Five patients were re-intervened: 3 due to intra-abdominal sepsis and 2 due to hemoperitoneum. Mortality was 10% (2 cases). In subsequent follow up there was 5% (1 case) of stenosis of the anastomosis.


CONCLUSIONS
Esophageal reconstruction technique which in specialist units has an acceptable mortality rate (10%) and an insignificant morbidity. Coloplasty was the technique most used on these patients.
Farran-Teixidó
Leandre
L
Servicio de Cirugía General y Digestiva, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. lfarran@aecirujanos.es
Miró-Martín
Mònica
M
Biondo
Sebastiano
S
Conde-Mouriño
Raquel
R
Bettonica-Larrañaga
Carla
C
Aranda Danso
Humberto
H
Sans-Segarra
Manel
M
Rafecas-Renau
Antonio
A
D003106:Colon / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation