[Our attitude in esophageal and gastric post-caustic lesions]

The authors present the experience of the surgery section in patients treatment with oesophagian or gastric lesions after caustic substances ingestion. From a group of 70 patients who were treated in a conservative way (with medicines and dilatations) 60 of them returned to the surgery for nourishment gastrostomy. In two cases, the oesophagian and gastric lesions was established preoperations trough radiologic examination and in thirteen cases the lesions were found intraoperation. The adopted attitude is exemplified presenting a case. Under a general anaesthesia is done a limited resection (about 3 cm) with termino-terminal anastomosis of the stenosed antral area keeping the vascular arches of the little and big gastric curvature. A minimal a la Gavriliu gastrostomy is mounted on the vertical area of the little curvature. Through the gastrostomy (Petzzer) probe is put a tube of perfusor to the first jejununal ansa. In the first 48 hours the Petzeer is used for the gastric drainage in the perfusor probe for feeding. After 48 hours the jejununal probe is taken away and the gastrostomic feeding begins. After six mouths from the caustic ingestion 25 patients come back again for oesophagian reconstruction. For 24 patients the Gavriliu I, II proceeding is applied and for a case it is used the small intestine ansa. They lost 3 patients (2 with gastric tube and 1 with intestinal ansa). The evolution in 24 years time was very good.