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Vol - 29, Issue - 01
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[This article belongs to Volume - 29, Issue - 01]
International Medical Journal
Journal ID
:
IMJ-06-01-2022-1164
Total View
:
427
Title
:
Esophageal conduit after esophagectomy
Abstract
: Surgeons have struggled with native esophagus restoration after resection. Conduit should be enough to link the cervical esophagus and abdominal gastrointestinal tract, have a good vascular supply for proper deglutition. Available conduits include stomach, jejunum and colon. However, stomach is not available as a possible conduit everytime and the possibility of alternative conduit should be kept in mind. This study discusses the practical aspects of stomach, colonic interposition in 36 cases of esophageal resection and replacement; and focusses on advantages of one over another. A prospective study between 2009-2021 at our institute in Pune. There were 36 patients (benign and malignant disease) requiring esophageal resection and replacement. Patients reviewed on the basis of gender, age, esophageal resection indication, type of surgery, indication for conduit selection, morbidity, mortality. There were 27 males and 9 females, 28 cases carcinoma esophagus, 7 cases caustic stricture, 1 case radiation stricture. 32 patients underwent gastric conduit, colonic interposition was done in 4 patients. 8 had cervical anastomotic leak and cardio-pulmonary complications. Duration of surgery was increased in colonic interposition group but, there were no complications. Hospital mortality was 5. Irrespective of the conduit used, no overall survival benefit was noted. Treatment of esophageal cancer weighs the risk vs benefit ratio in terms of survival and quality of life. Clinical decision-making regarding choice of conduit is crucial. The commonest organ used as an esophageal conduit is stomach. However, colon is used whenever stomach is diseased and cannot be used.
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