Colon Interposition Graft for Corrosive Esophageal Stricture: Midterm Functional Outcome

Abstract

Although the use of pedicled colonic interposition graft offers a good mid-term functional outcome with relief of dysphagia, early postoperative morbidity is high. Graft infarction is the single most important factor for poor functional outcome and every effort must be made to prevent its occurrence.

Case Report: POST ESOPHAGECTOMY ESOPHAGEAL RECONSTRUCTION IN ESOPHAGEAL INJURY DUE TO CAUSTIC MATERIALS

“…The shortest duration occurs when partial resection of the esophagus and reconstruction is done using gastric pull up. Bleeding during the operation is between 450-700 cc, which is similar to those in other serial reports (Ezemba 2014). In our series, no deaths were found during hospitalization, while in the larger series, the hospital mortality rate was between 3.3-9.5% (Ezemba 2014, Boukerrouche 2013.…”

“…The duration of surgery in our series was between 5-6.5 hours, while in other series, the reported durations were between 4.5-6.8 hours (Ezemba 2014) and 2.5-5 hours (Boukerrouche 2013). The shortest duration occurs when partial resection of the esophagus and reconstruction is done using gastric pull up.…”

“…In our series, no deaths were found during hospitalization, while in the larger series, the hospital mortality rate was between 3.3-9.5% (Ezemba 2014, Boukerrouche 2013. Colon interposition was reported to have satisfactory results, although the mortality rate in hospitals was still quite high, mainly due to graft death (Ezemba 2014, Hadidi 2006, Knezevic et al 2007, Bassiouny & Bahnassy 1992). …”

“…In the cases in our series, the caustic material was mostly HCl, while in other series of 85.7% was NaOH (Ezemba 2014). In all of our cases, the accidental drinking occurred because the liquid was assumed as drinking water (placed in incorrectly labeled bottle).…”

“…Historically, there is an option for reconstruction of the esophagus without resection of a stricture segment by using a flap, but this option has been abandoned because of complications and poor effectiveness (Yeo 2013). The main indications for bypass or resection and esophageal bypass are stricture with long segments and multiple strictures along the esophagus (Ezemba 2014). In short stricture, where the endoscope can still be passed and the guidewire can be installed, endoscopically dilatation can be performed.…”