Results of Pharyngocolostomy in Intractable Caustic Pharyngeal Stricture.
- Author:
Choong Gyu PARK
1
;
Young Mog SIM
;
Jhin Gook KIM
;
Kwan Min KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Esophageal stricture;
Esophageal reconstruction
- MeSH:
Cicatrix;
Colon;
Constriction, Pathologic*;
Deglutition;
Deglutition Disorders;
Esophageal Stenosis;
Esophagus;
Humans;
Postoperative Complications;
Pyriform Sinus;
Sternum;
Thyroid Cartilage;
Transplants;
Vocal Cord Paralysis
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1999;32(6):561-566
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It is not easy to surgically correct caustic pharyngeal strictures and a lot of effort is required to restore normal swallowing after the surgery. The authors reviewed the course in patients who underwent pharyngocolostomy. MATERIAL AND METHOD: From August 1995 to March 1998, 6 patients with caustic stricture underwent esophageal reconstruction surgery. The time of injury to the replacement of the esophagus was from 3 months to 2 years and 4 months. The left colon was used in all patients. The surgical route was used under the sternum in 5 patients and through the esophageal hiatus in 1 patient. In the cervical anastomoses, the cervical pharyngocolic anastomosis was performed on the left pyriform sinus after a partial resection of the thyroid cartilage in 3 patients and on the posterolateral aspect of the inferior pharyngeal constrictor in 3 patients. RESULT: Postoperative complications consisted of a dysphagia in 3 patients and left vocal cord palsy in 1 patient. There was no cervical anastomotic stricture. Revisional procedures consisted of an esophageal dilation and free jejunal graft in 1 patient, supraglottic scar band resection in 1 patient, and colonic mucosal resection in 1 patient. Swallowing training was required in the 3 patients with dysphagia. Restoration of normal swallowing was obtained in all patients between the 9th and the 303rd day. CONCLUSION: Pharyngocolostomy is a satisfactory method of treatment for patients with intractable caustic stricture. Pharyngocolojejunostomy is an effective alternative for esophagocologastrostomy in cases where gastric outlets are involved.
