BACKGROUND: Through a systematic policy of using the right colon as an esophageal substitute, the authors analyze the reliability of this transplant for reconstruction after digestive caustic injury. METHODS: From 1995 to 2005, a right coloplasty was attempted in 81 patients after total esophagogastrectomy (n = 57) or for esophageal stricture (n = 24). RESULTS: The use of the right colon was not possible in 10 patients (12%) because of insufficient blood supply. In addition, postoperative right colic graft necrosis occurred in 5 patients. Cervical fistula occurred in 25 patients (31%). Opening of the thoracic inlet was associated with a lower rate of this complication (P = .04). At the end of the follow-up, 71 patients (88%) recovered oral feeding. CONCLUSION: Attempt to use the right colon as an esophageal substitute failed in 18% of the patients. Despite high rates of cervical complications, in part linked to the peculiar setting of caustic injury, functional results remains satisfactory.
BACKGROUND: Through a systematic policy of using the right colon as an esophageal substitute, the authors analyze the reliability of this transplant for reconstruction after digestive caustic injury. METHODS: From 1995 to 2005, a right coloplasty was attempted in 81 patients after total esophagogastrectomy (n = 57) or for esophageal stricture (n = 24). RESULTS: The use of the right colon was not possible in 10 patients (12%) because of insufficient blood supply. In addition, postoperative right colic graft necrosis occurred in 5 patients. Cervical fistula occurred in 25 patients (31%). Opening of the thoracic inlet was associated with a lower rate of this complication (P = .04). At the end of the follow-up, 71 patients (88%) recovered oral feeding. CONCLUSION: Attempt to use the right colon as an esophageal substitute failed in 18% of the patients. Despite high rates of cervical complications, in part linked to the peculiar setting of caustic injury, functional results remains satisfactory.
Authors: Julián Alberto Saldaña-Cortés; Francisco Larios-Arceo; Emilio Prieto-Díaz-Chávez; Eliseo Portilla De Buen; Salvador González-Mercado; Andrea Socorro Alvarez-Villaseñor; Manuel Rodrigo Prieto-Aldape; Clotilde Fuentes-Orozco; Alejandro González-Ojeda Journal: World J Surg Date: 2009-05 Impact factor: 3.352
Authors: Jade Brown; Wyn G Lewis; Antonio Foliaki; Geoffrey W B Clark; Guy R J C Blackshaw; David S Y Chan Journal: J Gastrointest Surg Date: 2018-03-08 Impact factor: 3.452