Strategies in the Management of Failed Neck Anastomosis in Pharyngo Esophageal Reconstructions after Corrosive Injury Esophagus
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
AIM: To analyze and describe our management strategies of failed neck anastomosis in pharyngo esophageal reconstructions after corrosive injury esophagus. MATERIAL AND METHODS: About 23 patients who underwent conduit interposition for corrosive stricture esophagus presented with various complications. At the end of study, type of corrosive ingested, type of conduit and techniques used in primary surgery, etiology of failed neck anastomosis and mode of management were analyzed. RESULTS: Most of the patients consumed acid substance (95%), and only one patient consumed alkali (18.75%). Among 23 patients, the corrosive ingestion was suicidal in 20 patients and in three patients, it was accidental. Most common conduit was colon (87%). Of 20 patients who underwent colon bypass, Pharyngocolic type of anastomosis performed in 16 patients, esophagocolic anastomosis in 4 patients, 2 patients underwent esophagogastric anastomosis and one patient referred to our center with failed jejunal interposition for reconstruction. The frequent long term complication following esophageal replacement was an anastomotic stricture that occurred in 17 patients, in which 7 patients were managed by bougie dilatation and 10 patients with severe intractable stricture, revision was done using various surgical techniques. Swallowing function was restored in 20 of 23 patients. CONCLUSION: Esophageal reconstruction remains a major therapeutic challenge for surgeons, as morbidity rate continues to be high, inspite of major advances in intraoperative and postoperative care. Patients after such procedures should follow up in specialized centers and periodic examinations will be helpful in maintaining the function of conduit and quality of life.
Authors and Affiliations
Dr. Kesavan Balaraman, Dr. Kolandasamy Chinnusamy, Dr. Chandramohan SM
Keywords
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- EP ID EP423831
- DOI 10.9790/0853-1712053441.
- Views 55
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