Pharyngocolonic Anastomosis for Esophageal Reconstruction in Corrosive Esophageal Stricture

Abstract Background Ingestion of corrosive agents remains an important public health problem. Early endoscopic examination of post-corrosive esophageal injuries has an important role in management of the patient. Publications document the risk of developing esophageal stricture as a sequential complication of esophageal injury grades 2b and 3a. Although there are studies describing the risk factors of post-corrosive stricture, there is limited literature on these factors. The aim of this study was to evaluate the different factors with post-corrosive esophageal stricture and non-stricture groups in endoscopic grades 2b and 3a of corrosive esophageal injuries. Methods Data were retrospectively analyzed in the patients with esophageal injury grades 2b and 3a between January 2011 and December 2017. Results 196 corrosive ingestion patients were admitted with 32 patients (15.8%) in grade 2b and 12 patients (6.1%) in grade 3a and stricture was developed in 19 patients (61.3%) with grade 2b and in 10 patients (83.3%) with grade 3a. Substances of alkaline reaction were predominant in stricture patients (68.4% in 2b Stricture group, 60% in 3a Stricture group). The patients’ height of non-stricture group was greater than that of stricture groups (2b Stricture group, 1.58 ± 0.08 m, 2b Non-stricture group, 1.66 ± 0.07 m, P < 0.004; 3a Stricture group, 1.52 ± 0.09 m, 3a Non-stricture group, 1.71 ± 0.02 m, P < 0.001). Omeprazole was more commonly used in non-stricture than stricture group (26.3% in 2b Stricture group, 69.2% in 2b Non-stricture group, P = 0.017; 50% in 3a Stricture group, 100% in 3a Non-stricture group, 1.71 ± 0.02 m, P = 0.015). Conclusion In this study, the corrosive esophageal injuries grades 2b and 3a are important groups of patients who are at risk of developing post-corrosive esophageal stricture. Alkaline substances play the major role in stricture sequelae. The height of patients and the prescription of omeprazole may help to minimize the risks of post-corrosive esophageal stricture. Disclosure All authors have declared no conflicts of interest.

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Long-term management of corrosive esophageal stricture with balloon dilation in children

Surgical Endoscopy ◽

10.1007/s00464-010-0953-x ◽

2010 ◽

Vol 24 (9) ◽

pp. 2287-2292 ◽

Cited By ~ 31

Author(s):

Abdulkerim Temiz ◽

Pelin Oguzkurt ◽

Semire Serin Ezer ◽

Emine Ince ◽

Akgun Hicsonmez

Keyword(s):

Esophageal Stricture ◽

Balloon Dilation ◽

Corrosive Esophageal Stricture ◽

Term Management

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Endoscopic mucosal autograft for treating esophageal caustic strictures: preliminary human experience

Endoscopy ◽

10.1055/a-0622-8019 ◽

2018 ◽

Vol 50 (10) ◽

pp. 1017-1021 ◽

Cited By ~ 2

Author(s):

Kexin He ◽

Lili Zhao ◽

Shoushan Bu ◽

Li Liu ◽

Xiang Wang ◽

...

Keyword(s):

Complete Remission ◽

Clinical Efficacy ◽

Esophageal Stricture ◽

Normal Diet ◽

Endoscopic Dilation ◽

Mucosal Regeneration ◽

Functional Regeneration ◽

Corrosive Esophageal Stricture ◽

Caustic Stricture

Abstract Background Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. Methods Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation. Results All procedures were successful with no severe complications. Mucosal regeneration was shown at the transplanted segments. One patient was able to maintain a normal diet with complete remission after 1 year of follow-up. Intraluminal stenosis and dysphagia were significantly improved in another two patients. Conclusions Mucosal autografting can achieve esophageal re-epithelialization, inhibit undesired fibrosis, prevent restenosis, and promote functional regeneration.

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Esophageal Reconstruction for Esophageal Stricture after Corrosive Injury.

Nippon Jibiinkoka Gakkai Kaiho ◽

10.3950/jibiinkoka.102.976 ◽

1999 ◽

Vol 102 (8) ◽

pp. 976-982 ◽

Cited By ~ 2

Author(s):

Chihiro Hatta ◽

Hiroshi Ogasawara ◽

Masakazu Tsuyu ◽

Masao Kakibuchi ◽

Nobuyuki Yamada ◽

...

Keyword(s):

Esophageal Stricture ◽

Esophageal Reconstruction ◽

Corrosive Injury

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Successful Esophageal Replacement Surgery in a 3-Year Old with Post-corrosive Esophageal Stricture

Annals of African Surgery ◽

10.4314/aas.v17i2.9 ◽

2020 ◽

Vol 17 (2) ◽

pp. 80-84

Author(s):

Cleopas Mutua Kaumbulu ◽

Mark Nelson Awori ◽

Rohini Patil ◽

Ahmed Mohamed Rafik ◽

James Ndung'u Muturi

Keyword(s):

Developing Countries ◽

Conservative Management ◽

Esophageal Stricture ◽

Esophageal Replacement ◽

Caustic Ingestion ◽

Medical Facility ◽

Replacement Surgery ◽

Corrosive Esophageal Stricture ◽

Complex Surgical Procedures ◽

Type Of Injury

Accidental caustic ingestion in children, though entirely preventable, continues to be present in developing countries. Gastrointestinal injuries following caustic ingestion in children range from mild to fatal. Presentation of such children to the medical facility could be early or sometimes late with complications. Management is based on the type of injury and could range from medical conservative management to complex surgical procedures. Such complex surgeries are almost unavailable in developing countries. We present a 3-year old who presented to our facility with an esophageal stricture following accidental caustic ingestion four months prior to presentation. He had a failed stricture dilatation and needed to be managed surgically; he subsequently had a good outcome, which is rare in developing countries. Keywords: Post-corrosive esophageal stricture, Esophageal replacement surgery

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Surgical treatment of acquired tracheoesophageal fistula caused by balloon dilatation of corrosive esophageal stricture in a child

Vojnosanitetski pregled ◽

10.2298/vsp180615169s ◽

2020 ◽

Vol 77 (10) ◽

pp. 1097-1100

Author(s):

Dejan Stojakov ◽

Maja Milickovic ◽

Predrag Minic ◽

Miroslav Vukadin ◽

Nikola Stankovic ◽

...

Keyword(s):

Balloon Dilatation ◽

Tracheoesophageal Fistula ◽

Esophageal Stricture ◽

Therapeutic Option ◽

Functional Results ◽

Female Child ◽

Thoracic Esophagus ◽

Pharyngoesophageal Reconstruction ◽

Life Threatening ◽

Corrosive Esophageal Stricture

Introduction. Tracheoesophageal fistula (TEF) as a complication of balloon dilatation (BD) of corrosive esophageal stricture is a very rare and serious condition. Life threatening aspiration pneumonia requests urgent lungs' protection, but overall treatment strategy is not clearly defined. Case report. Twenty-month-old female child accidentally ingested a household bleach. Caustic injury of esophagus was healing with development of strictures of cervical and proximal thoracic esophagus. TEF was developed during the third BD. Healing of TEF and pulmonary infection was achieved by exclusion of the esophagus (pharyngostoma and feeding gastrostomy together) with prolonged tracheobronchial intubation and toilette. Retrosternal colon interposition was performed a year later, with excellent functional results over four-year follow-up. Conclusion. Esophageal exclusion in the first stage, and pharyngoesophageal reconstruction in the second stage, is a useful therapeutic option in the treatment of TEF caused by balloon dilatation of corrosive esophageal stricture in children.

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