• Journal of Chest Surgery
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• v.32 no.6
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• pp.561-566
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• 1999

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.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.445-449
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• 2005

The management of failure of colonic graft or corrosive stricture with impaired colonic circulation continues to be a challenge to surgeons. We present four cases of complicated corrosive esophageal stricture, which were successfully treated using jejunal free graft. As the initial surgical treatment, three patients underwent colonic interposition, and one underwent Whipple's procedure due to panperitonitis. Ore patient underwent transposition of jejunal free patch graft, two underwent interposition of jejunal free graft, and one underwent esophagojejunocolojejunostomy using jejunal free graft. All patients did not show dysphagia after long term follow-up. Complex esophageal reconstruction with jejunal free graft was performed successfully and long term functional outcome was good.