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Late complications after pharyngogastrostomy

J Endrédi¹, O P Horváth

¹1st Surgical Department, Medical University of Pécs, Hungary.

Acta Chirurgica Hungarica

|January 1, 1997

Summary

Severe stricture and tracheogastric fistula are rare, devastating complications after cervical esophageal cancer surgery. Surgical management, including free jejunal transfer for stricture and flap reconstruction for fistula, offers potential palliation or definitive treatment.

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Area of Science:

Gastroenterology
Surgical Oncology
Otolaryngology

Background:

Laryngopharyngo-esophagectomy and pharyngogastrostomy for cervical esophageal cancer can lead to severe complications.
Strictures and tracheogastric fistulas are known, albeit rare, post-operative sequelae.

Observation:

This report details two cases: one with severe stricture and another with a tracheogastric fistula following the described surgical procedures.
Both conditions are associated with poor prognoses and significant patient morbidity.

Findings:

Surgical management for stricture involved free jejunal transfer after failed dilation, achieving over 24 months of survival.
Tracheogastric fistula was treated with gastric repair and a sternocleidomastoid flap, but survival was limited to two weeks.

Implications:

Effective surgical strategies are crucial for managing these devastating post-operative complications.
Free jejunal interposition shows promise for stricture management, while tracheogastric fistula treatment remains challenging.
Optimizing patient condition and ruling out recurrence are critical prerequisites for surgical intervention.

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