Top

Published in:

01-01-2018 | Original Scientific Report

Utilization of Gastric Conduit in the Management of Combined Corrosive Esophageal and Stomach Stricture

Authors: Vaibhav Kumar Varshney, Sundeep Singh Saluja, Pramod Kumar Mishra, Kshitij Sisodia, Ashish Sachan, Pushp Sheetal

Published in: World Journal of Surgery | Issue 1/2018

Abstract

Background

Corrosive stricture of esophagus may be associated with variable involvement of stomach. We analyzed the outcome of gastric conduit used in the management of corrosive esophageal stricture with concomitant antro-pyloric stricture.

Study design

Among 101 esophageal replacements performed, 53 patients had combined esophagus and stomach strictures. Colon was used as a conduit in 43 patients, while stomach was used in ten patients. Indications, perioperative complications and early/late outcomes of patients with gastric pull-up were reviewed and compared with those undergone colon pull-up.

Results

The indications of using gastric conduit were impromptu in four patients [colonic conduit ischemia (n = 2) and an oversight of antro-pyloric stricture after forming the gastric conduit (n = 2)]. Six patients had preconceived gastric conduit (distal antro-pyloric stricture with distended stomach). The median age was 29 years (range 16–50), and median BMI was 15.4 kg/m² (range 14.5–20.1). The stomach was drained using loop gastrojejunostomy (n = 7) or Roux-en-Y gastrojejunostomy (n = 3). One patient died due to sepsis secondary to anastomotic leak. Median hospital stay was 9 days (range 7–22). At median follow-up of 25 months (range 14–80), the remaining nine patients are able to have solid diet and have gained weight. The level of esophageal stricture was low (p = 0.01), and duration of surgery (p = 0.02) and median hospital stay (p = 0.04) were significantly less in patients with gastric conduit plus drainage as compared to patients undergone colonic pull-up.

Conclusion

Gastric conduit in a subject with distal antro-pyloric stricture can be used safely along with gastrojejunostomy in selected patients of corrosive esophageal stricture.

Chaudhary A, Puri AS, Dhar P et al (1996) Elective surgery for corrosive-induced gastric injury. World J Surg 20:703–706. doi:10.1007/s002689900107 CrossRefPubMed

Agarwal S, Sikora SS, Kumar A, Saxena R, Kapoor VK (2004) Surgical management of corrosive strictures of stomach. Indian J Gastroenterol 23:178–180PubMed

Tohda G, Sugawa C, Gayer C, Chino A, McGuire TW, Lucas CE (2008) Clinical evaluation and management of caustic injury in the upper gastrointestinal tract in 95 adult patients in an urban medical centre. Surg Endosc 22:1119–1125CrossRefPubMed

Brown RA, Miller AJ, Numanoglu A, Rode H (2002) Y-V advancement antropyloroplasty for corrosive antral strictures. Pediatr Surg Int 18:252–254CrossRefPubMed

Knezevi JD, Radovanovi NS, Simi AP, Kotarac MM, Skrobi OM, Konstantinovi VD et al (2007) Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience. Dis Esophagus 20:530–534CrossRef

Deng B, Wang RW, Jiang YG et al (2008) Prevention and management of complications after colon interposition for corrosive esophageal burns. Dis Esophagus 21:57–62CrossRefPubMed

Peters JH, Meester TR, Stein HJ (1995) Surgical therapy for cancer of the esophagus and cardia. In: Castell DO (ed) The esophagus, 2nd edn. Little Brown, New York, pp 293–335

Ananthakrishnan N, Rao KS, Radjendirin P (1993) Mid-colon oesophagocoloplasty for corrosive oesophageal strictures. Aust N Z J Surg 63:389–395CrossRefPubMed

Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1992) Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. Am J Gastroenterol 87:337–341PubMed

10.

Sharma S, Debnath RP, Agrawal LD, Gupta V (2007) Gastric outlet without esophageal involvement: a late sequelae of acid ingestion in children. J Indian Assoc Pediatr Surg 12:47–49CrossRef

11.

Ananthakrishnan N, Parthasarathy G, Kate V (2010) Chronic corrosive injuries of the stomach-a single unit experience of 109 patients over thirty years. World J Surg 34:758–764. doi:10.1007/s00268-010-0393-8 CrossRefPubMed

12.

Subbarao KS, Kakar AK, Chandsekhar V, Ananthakrishnan N, Banerjee A (1988) Cicatricial gastric stenosis caused by corrosive ingestion. Aust N Z J Surg 58:143–146CrossRefPubMed

13.

Ciftci AO, Senocak ME, Buyukpamukcu N, Hicsonmez A (1999) Gastric outlet obstruction due to corrosive ingestion—incidence and outcome. Pediatr Surg Int 15:88–91CrossRefPubMed

14.

Shukla RM, Mukhopadhyay M, Tripathy KC, Mandal KC, Mukhopadhyay B (2010) Pyloric and antral strictures following corrosive acid ingestion: a report of four cases. J Indian Assoc Pediatr Surg 15:108–109CrossRefPubMedPubMedCentral

15.

Ansari MM, Haleem S, Harris SH, Khan R, Zia I, Beg MH (2011) Isolated corrosive pyloric stenosis without oesophageal involvement: an experience of 21 years. Arab J Gastroenterol 12:94–98CrossRefPubMed

16.

Hugh TB, Kelly MD (1999) Corrosive ingestion and the surgeon. J Am Coll Surg 189:508–522CrossRefPubMed

17.

Kim YT, Sung SW, Kim JH (2001) Is it necessary to resect the diseased esophagus in performing reconstruction for corrosive esophageal stricture? Eur J Cardiothorac Surg 20:1–6CrossRefPubMed

18.

Mamede RC, de Mello Filho FV (2001) Ingestion of caustic substances and its complications. Sao Paulo Med J 119(1):10–15CrossRefPubMed

19.

Kochhar R, Sethy PK, Kochhar S, Nagi B, Gupta NM (2006) Corrosive induced carcinoma of the esophagus: report of three patients and review of literature. J Gastroenterol Hepatol 21:777–780CrossRefPubMed

20.

Nagi B, Kochhar R, Thapa BR, Singh K (2004) Radiological spectrum of late sequelae of corrosive injury to upper gastrointestinal tract. A pictorial review. Acta Radiol 45:7–12CrossRefPubMed

21.

Sharma P, Pancholi M, Patel G, Sharma A (2015) Side-to-side esophagogastro-jejunoplasty in post-corrosive stricture of distal esophagus and proximal stomach. Indian J Surg 77(Suppl 3):1469–1472CrossRefPubMedPubMedCentral

Title: Utilization of Gastric Conduit in the Management of Combined Corrosive Esophageal and Stomach Stricture
Authors: Vaibhav Kumar Varshney
Sundeep Singh Saluja
Pramod Kumar Mishra
Kshitij Sisodia
Ashish Sachan
Pushp Sheetal
Publication date: 01-01-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 1/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4167-4

At a glance: The STEP trials

Springer Medicine

Utilization of Gastric Conduit in the Management of Combined Corrosive Esophageal and Stomach Stricture

Abstract

Background

Study design

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Study design

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2018

Are American Surgical Residents Prepared for Humanitarian Deployment?: A Comparative Analysis of Resident and Humanitarian Case Logs

Tube Thoracostomy Complications: More to Learn

Lower Extremity Bypass Using Bovine Carotid Artery Graft (Artegraft): An Analysis of 124 Cases with Long-Term Results

Comparison of Prognostic Abilities Among Preoperative Laboratory Data Indices in Patients with Resectable Gastric and Esophagogastric Junction Adenocarcinoma

Younger Age is an Independent Factor for Graft Weight Overestimation: Analysis of the Clinical Impact on Recipient Outcomes in 340 Japanese Living Liver Donors

Short- and Long-Term Outcomes in Malnourished Patients After Laparoscopic or Open Radical Gastrectomy