Gastric antral patch esophagoplasty for extensive corrosive stricture of the esophagus.

A case is reported of a patient with a 9-cm stricture of the esophagus caused by ingestion of sodium hydroxide, who was treated by gastric antral patch esophagoplasty. In this procedure, a full-thickness pedicled patch of gastric antrum, based on the left gastroepiploic artery, was used to enlarge the esophageal lumen, thus allowing preservation of esophageal continuity and utilization of a functioning lower esophageal sphincter. The patient ate normally after the operation, and radiological, manometric, and esophageal pH monitoring studies indicated satisfactory esophageal function. Gastric antral patch esophagoplasty avoids the complications associated with esophageal bypass or resection. Previous long-term results of this procedure in patients with reflux-induced esophageal stricture have been good, and the technique merits consideration in the treatment of severe corrosive strictures.