Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series

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ZANGI MAHDI; SAGHEBI SEYED REZA; Biharas Monfared Ali; LAJEVARDI SEYED AMIRMOHAMMAD; BEHGAM SHADMEHR MOHAMAD

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Journal: TANAFFOS Year:2017 | Volume:16 | Issue:1 Page(s): 68-75

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Title

Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series

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Keywords

Colopharyngoplasty

Pharyngoesophageal stricture (PES)

Corrosive injury

Caustic injury

Abstract

Background: Pharyngoesophageal strictures (PES) after Corrosive injury impose a problematic condition for both physicians and patients in terms of their management and patients’ quality of life. Colopharyngoplasty is a complex procedure, which is used to restore swallowing in these severely disabled patients. We describe our experience in treating nine patients with severe PES after corrosive injuries in a referral center. Materials and Methods: A retrospective analysis of our database from 2009 to 2014 showed nine patients (seven men; age range: 18 to 47 years) with severe PES who underwent Colopharyngoplasty ~6 months (range: 4-10) after caustic material ingestion. All patients had a feeding jejunostomy tube before reconstruction. Esophagectomy with or without gastrectomy was performed in all patients, except for one; thereafter, an isoperistaltic segment of the left colon was pulled up, and a pharyngocolic anastomosis was performed. Eight patients had a tracheostomy created either before reconstruction due to respiratory symptoms or at the time of definitive surgery to prevent aspiration in the early post-operative period. Results: Almost all survivors had a satisfactory swallowing at the end of the follow-up (range: 4-60 months). The jejunostomy tube could be removed in all of the patients after a median of 5 months. One patient died of sepsis due to graft necrosis in the immediate post-operative period. Another patient died 5 months after the first surgery following a revision surgery for intractable dysphagia. At the end of the follow-up, only one patient tolerated tracheostomy tube decannulation. Two patients required laryngotracheal dissociation because of massive aspiration and recurrent episodes of pneumonia. Five patients still had a tracheostomy because of an severely destroyed larynx (two patients) and aspiration (three patients). Conclusion: Colopharyngoplasty is considered a complicated but trustworthy procedure to restore gastrointestinal tract continuity after severe Corrosive injury. Undeniably, laryngeal involvement adversely affects the functional outcome. The post-operative course is frequently protracted, accompanied with several problems. Aspiration is nearly the most problematic event in the early post-operative period, which mandates a multidisciplinary approach to manage it.

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APA: Copy

ZANGI, MAHDI, SAGHEBI, SEYED REZA, Biharas Monfared, Ali, LAJEVARDI, SEYED AMIRMOHAMMAD, & BEHGAM SHADMEHR, MOHAMAD. (2017). Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series. TANAFFOS, 16(1), 68-75. SID. https://sid.ir/paper/718252/en

Vancouver: Copy

ZANGI MAHDI, SAGHEBI SEYED REZA, Biharas Monfared Ali, LAJEVARDI SEYED AMIRMOHAMMAD, BEHGAM SHADMEHR MOHAMAD. Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series. TANAFFOS[Internet]. 2017;16(1):68-75. Available from: https://sid.ir/paper/718252/en

IEEE: Copy

MAHDI ZANGI, SEYED REZA SAGHEBI, Ali Biharas Monfared, SEYED AMIRMOHAMMAD LAJEVARDI, and MOHAMAD BEHGAM SHADMEHR, “Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series,” TANAFFOS, vol. 16, no. 1, pp. 68–75, 2017, [Online]. Available: https://sid.ir/paper/718252/en

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