Clinical surgery–internationalEsophageal reconstruction after caustic injury: is there still a place for right coloplasty?
Section snippets
Patients
Eighty-one patients, who had an esophageal coloplasty for reconstruction after caustic injury between 1995 and 2005, were reviewed retrospectively. There were 32 women and 49 men. Their median age was 38 years (range 17 to 77 years). Caustic ingestion was accidental in 10 patients and suicidal in 71 (88%). Fifty-seven patients (70%) had undergone an emergency esophagogastrectomy performed by a stripping procedure [5] and 24 patients (30%) developed a secondary esophageal stricture unresponsive
Operative data
Median delay from caustic injury to esophagoplasty was 5 months (range 3 months to 50 years). Median preoperative ASA score was 1 (range 1 to 3). Median operative time was 5.5 hours (range 3 to 11 hours). In patients without pharyngeal stricture (n = 47; 58%), an esophagoileal anastomosis was performed in 40 patients (85%) and an esophagocolic anastomosis in 7 patients. A pharyngoplasty was associated to the esophagoplasty in 34 patients (42%) using the distal colon in 20 patients (60%), the
Comments
The colon has been widely used as an esophageal substitute following esophagectomy for carcinoma or for benign conditions such as congenital malformations, motility disorders, perforations, or caustic burns [13], [14], [15], [16], [17], [18]. To date, the choice between right and left colon for esophagoplasty is still debated, and results of both techniques are difficult to compare due to disparities in patients and surgical techniques in the reported series. In the present series, the choice
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