Surgical Treatment of Corrosive Stricture of Esophagus and Stomach

Abstract

A total of 30 case of esophageal and gastric caustic strictures were dealt with in Mayo Hospital from March, 1987 to August, 1996. Surgical Treatment included transhiatal oesophagectomy without thoracotomy in 26 cases, surgical by pass in 4 cases. Reconstructive procedures involved the posterior mediastinal route in 24 cases and sub sternal route (retrosternal) in 6 cases. Esophageal substitutes used for reconstruction were, stomach (26 cases), colon (4 cases); all the esophageal substitutes were isoperistaltic. Complications included hoarseness of vice, unilateral pleural injury and cervical anastomotic leak. There was no operative, or perioperative death. Post-operative swallow junction was considered good in 27 cases (90%). In our experience, transhiatal oesophagectomy without thoracotomy is an ideal procedure for caustic strictures of the esophagus.in case of complicated strictures of the esophagus such as perforation of the esophagus, surgical bypass is an alternative procedure. Isoperistaltic stomach is the best option for esophageal replacement but when the stomach is also involved such as antral fibrosis, colon is an optimistic alternative.