Experience in oesophageal substitution in Lagos, Nigeria

This is an audit of five years work (1996 - 2001), in oesophageal substitution at the Cardiothoracic Surgery Unit of Lagos University Teaching Hospital, Nigeria. The study aimed at highlighting the current trends in indication and methods of oesophageal substitution in the context of our experience. We did a retrospective study of all who required oesophageal substitution during the period of study. We studied the various aspects of the patients' care including the indications for oesophageal substitution, the substituting organs and the results of surgery. We saw fifty-nine patients comprising 19 patients oesophageal carcinoma, 31 corrosive strictures of the oesophagus, 4 peptic strictures and 3 achalasia cases. Two patients had oesophageal substitution because of mediastinitis. Fifty-five patients underwent oesophageal substitution. The substituting organs were stomachs in 36 patients and colon in 19 patients. There were three anastomotic strictures, two grafts failed, and five cases of anastomotic leaks. In all, operative mortality was 9.1% . We concluded that oesophageal substitution was done more for benign reasons in our centre. We also emphasised the positive aspects of colon interposition and the prospects of doing more of it in the near future.