Esophagoplasty in Non-Standard Situations

Background. Independent of the causes that make nourishment by the mouth impossible, the damage of the esophagus requires its reconstruction in which the stomach or a segment of the intestine is used. The kind of the productive intervention is determined by both anatomical and technical options and has to be chosen individually for each patient. Surgical procedures have to be performed in one or in a few stages. Objectives. The paper presents esophagoplasty in non-standard situations. Material and Methods. 5 patients of both sexes (F-1, M-4) were operated on in non-standard situations. The youngest woman was 21 years old and the oldest man was 65 years old. 1 woman was operated on because of esophageal atresia. 1 man because an injury of the neck with tearing of the throat, larynx and esophagus. 2 men because of Boerhaave's syndrome. 1 man, because of invasive planoepitheliale carcinoma of the esophagus, had esophagectomy at the same time as gastric tube pull-up. 5 days after the operation, because of the ischemia and necrosis of the stomach, removal of the stomach, salivary fistula and jejunostomy was made. All the patients had supplementary esophagus made from right half of the colon. Results. No complications were reported in the postoperative period. No one died. Radiographic (gastrographine) examination was performed 7 days after surgery. The passage of contrast by the supplementary esophagus was efficient and patients began to consume liquids. 9 days after surgery, patients were able to consume all kinds of food. In the follow-up examination, all patients described their quality of life as satisfying. They could eat different kinds of food with no dysphagia. Conclusions. The kind of intestinal segment used for the esophagoplasty depends on the function of blood supply and technical options. Our experience shows that supplementary esophagus produced from a segment of the ileum and right half of the colon in an isoperistaltic arrangement are functionally better than other segments of the large intestine, particularly in an antiperistaltic arrangement (Adv Clin Exp Med 2011, 20, 4, 489-494).