title: Surgical treatment of caustic esophageal strictures in adults.
abstract: OBJECTIVE
  Caustic esophageal injury is a rare clinical condition in adult patients. Although dilatation, or the conservative approach, is the primary treatment method, some patients require surgical intervention. Because of the rarity of such cases, standard surgical treatment algorithms cannot be utilized. In this article, we present our surgical experience and discuss the challenges in the surgical management of corrosive injury of the esophagus in adults.
  
  
  METHODS
  A retrospective review was conducted of 28 patients who suffered from a corrosive esophageal injury between 1996 and 2011. Patient demographics, history of corrosive material ingestion, preoperative findings, treatment strategy, operative technique, postoperative course, requirements for further treatment, and the current status of the patients were investigated.
  
  
  RESULTS
  All patients underwent a transhiatal esophagectomy in addition to a gastric pull-up with a cervical esophagogastrostomy. The mean follow-up time was 62 (12-140) months. One patient developed a deep surgical infection; anastomotic stenosis was noted and treated with dilatation in 13 patients. The mean time period between the operation and the first dilatation for 12 patients was 81 (45-161) days. The mean dilatation count for the patients was 3 (1-10).
  
  
  CONCLUSIONS
  Although it comes with high anastomotic stenosis rates, transhiatal esophagectomy and gastric pull-up with cervical anastomosis is a safe procedure, which can be performed for the treatment of corrosive esophageal stricture.
authors.affiliation: Gülhane Military Medical Academy, Gulhane Medical School, Department of General Surgery, GATA Genel Cerrahi AD., Etlik, Ankara 06018, Turkey. aharlak@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Harlak
authors.forename: Taner
authors.initials: T
authors.lastname: Yigit
authors.forename: Kagan
authors.initials: K
authors.lastname: Coskun
authors.forename: Tahir
authors.initials: T
authors.lastname: Ozer
authors.forename: Oner
authors.initials: O
authors.lastname: Mentes
authors.forename: Bulent
authors.initials: B
authors.lastname: Gülec
authors.forename: Orhan
authors.initials: O
authors.lastname: Kozak
mesh_terms: D000328:Adult; D002057:Burns, Chemical / Q000601:surgery; D002424:Caustics / Q000506:poisoning*; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004946:Esophagostomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013406:Suicide, Attempted
chemical_list: D002424:Caustics