[Esophageal substitute corrective operations]

In the Clinic of Gastrointestinal Surgery at the Medical University in Wrocław in 402 cases substernal oesophageal reconstruction was performed using different pedunculated oesophageal substitutes. 63 patients had to be operated on for the second time because of disorders in the oesophageal substitute. In 13 cases stenosis in the upper anastomosis and in 3 patients stenosis in the anastomosis with stomach were corrected. In 7 cases oesophageal ulcer was excised. 6 patients were operated because of substitute herniation into pleural cavity. In 3 cases huge diverticula in the neck were removed. 5 patients were operated because of stomach outlet stenosis. In 15 cases operation was necessary to correct the sequel of reflux oesophagitis. In 8 cases the surgery was performed to remove stenosis of the substitute. In 2 cases there was torsion of substitute and in the other 2 cases postoperative stenosis was caused by adhesions. One patient was operated because of the dumping syndrome. In 2 patients with the colon substitute polyps from the segment used for the oesophagus were removed endoscopically. The mortality after corrective surgery on the oesophageal substitute was less than 10% (6/63).