[Coloesophagoplasty, a choice operation for postcaustic esophageal stenosis].

OBJECTIVE

To evaluate the problems of approach, of technique and of care as a 20 years experience demonstrates.

MATERIAL AND METHOD: a retrospective study including 45 operated cases where the large-bowel served as reconstructive material (in 33 cases the transverse colon and in 12 cases right ileocolon).

RESULTS

Healing was obtained in 42 patients. Early postoperative evolution presented: peritonitis caused by anastomotic leakages--2 cases, hemoperitoneum--2 cases, cervical fistula --1 case, wound infection--6 cases, evisceration--1 case, acute respiratory failure--6 cases. Cervical anastomosis reconstruction for late stenosis--1 case. There were 2 postoperative deaths by haemorrhagic shock and peritonitis--mortality 4.4.

DISCUSSIONS: Reconstruction by using the large-bowel was justified through anatomic argumentation (sufficient vascular supply), technic argumentation (easy anastomosis, tension free, short time of execution), functional argumentation (good compliance of large-bowel to the new function).

CONCLUSION

Coloesophagoplasty is an efficient method on the condition of a strict planning: continent gastrostomy and evolvement of vascular arcades due to previous vascular "carving".