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Oesophageal reconstruction using the stomach.

O Osinowo1, T Alonge

  • 1Department of Surgery, University College Hospital, Ibadan, Nigeria.

West African Journal of Medicine
|October 1, 1992
PubMed
Summary
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Esophageal replacement using the stomach showed good outcomes for benign strictures but poor results for esophageal carcinoma. Surgical approaches varied, with transhiatal esophagectomy noting more complications.

Area of Science:

  • Thoracic Surgery
  • Gastroenterology
  • Surgical Oncology

Background:

  • Esophageal replacement is a critical procedure for various esophageal pathologies.
  • The use of gastric conduits for esophageal substitution has been widely adopted.
  • Outcomes can vary significantly based on the underlying indication and surgical technique.

Purpose of the Study:

  • To evaluate the outcomes of esophageal replacement using the stomach.
  • To analyze the results based on different indications, including carcinoma and benign strictures.
  • To compare the morbidity and mortality associated with various surgical approaches.

Main Methods:

  • Retrospective analysis of 47 esophageal replacement procedures using the stomach.
  • Procedures performed between January 1975 and December 1989 at University College Hospital, Ibadan.

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  • Data collected on patient demographics, indications, surgical approaches, complications, and outcomes.

    • Main Results:

    • Overall survival was 54.7% with good functional results (absence of dysphagia).
    • High mortality (58.8%) observed in patients with esophageal carcinoma.
    • Benign strictures (corrosive, peptic) showed better survival rates.
    • Transhiatal esophagectomy was associated with higher morbidity compared to other routes.
    • Intra-operative mortality was 4.3%.

    Conclusions:

    • Gastric esophageal replacement is effective for benign conditions, offering good long-term results.
    • The procedure yields poor outcomes for esophageal carcinoma in this setting, necessitating alternative strategies.
    • Surgical approach selection impacts morbidity; careful consideration is advised.