[Experience in repeated esophagoplasty]

Experience in repeated esophagoplasty in 58 patients is analyzed. Fifty-four patients of them had reoperation because of incomplete plastic reconstruction, 4 patients -- because of artificial esophagus (cancer, papillomatosis, trauma) diseases. Primary esophagoplasty in 47 patients was performed due to burn stricture of the esophagus, in 9 -- due to cancer of the cardia and esophagus, in 1 -- due to peptic stricture, and in 1 -- due to leiomyoma of the esophagus. The causes of unsuccessful esophagoplasty were the following: necrosis of the transplant (28 patients), extensive obliteration of cervical anastomosis (6), insufficiency of intrapleural anastomosis (4), initially short length of the transplant (4), doubtful vitality of the transplant (1 patient). Subtotal repeated reconstruction of the esophagus was performed in 34 patients, total -- in 21, segmental (with a fragment of the intestine on a long vascular pedicle) -- in 3 patients. Left half of the colon was used as new material in 38 patients, small intestine -- in 12, ileocolon -- in 4, stomach -- in 3 patients. Repeated restrosternal esophagoplasty with left half of the colon was performed most often (27 patients). Reconstruction was completed in 55 patients. Complications were seen in 19 patients. There were no cases of hospital lethality. Long-term results were followed up in 49 patients, stricture of cervical anastomosis has diagnosed in 17 of them. Result of repeated esophagoplasty was good in 26 patients, satisfactory -- in 19, poor -- in 4 patients.