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Colon interposition for pharyngoesophageal postcorrosive strictures
Nebojsa Radovanović1, Aleksandar Simić, Milutin Kotarac
1Department of Foregut Surgery, First Surgical University Hospital, Institute for Digestive Diseases, Clinical Center of Serbia, Belgrade, Koste Todorovića 6, 11 000 Belgrade. chjserbia@hotmail.com
Hepato-Gastroenterology
|May 21, 2009
Summary
Colon interposition surgery offers excellent long-term results for pharyngoesophageal caustic injuries. This 40-year study shows a safe and effective method for esophageal reconstruction, improving quality of life.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Otolaryngology
Background:
- Pharyngoesophageal caustic injuries can lead to severe strictures requiring esophageal reconstruction.
- Colon interposition has been utilized as a reconstructive technique for decades.
Purpose of the Study:
- To report on a 40-year surgical experience with colon interposition for pharyngoesophageal caustic injury.
- To evaluate the long-term outcomes, complications, and functional results of this procedure.
Main Methods:
- A retrospective review of 83 colon interpositions performed between 1965 and 2005 for pharyngeal and high esophageal injuries.
- Patients were categorized by stricture level: supraglottic, hypopharyngeal, and esophageal ostium.
- Surgical approaches included extrapleural retrosternal bypass (89.1%) and colon interposition with esophagectomy (10.9%).
Main Results:
- Early postoperative complications occurred in 16.8% of patients, with anastomotic leakage being most frequent.
- The intrahospital mortality rate was 6%, and late postoperative complications were observed in 14.4%.
- Excellent functional results were achieved in 86.7% of patients with long-term follow-up (up to 30 years).
Conclusions:
- Colon graft serves as an excellent esophageal substitute for pharyngoesophageal corrosive strictures.
- When performed by experienced teams, colon interposition offers low morbidity and mortality.
- The procedure ensures a good and functional quality of life for patients long-term.
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