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Management of long segment corrosive esophageal stricture in children and adults: A 5 years' review
Ismail Mohammed Inuwa1, Jameel Ahmad Ismail1, Nurein Tunde Oyebanji1, Lofty-John Chukwuemeka Anyanwu2, Sani Ali Aji3, Mohammad Aminu Mohammad2, Abubakar Umar4, Nuhu Garba5, Ibrahim Aliyu6
1 Department of Surgery, Cardiothoracic Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Surgery, Paediatric Surgery Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
3 Department of Surgery, Urology Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
4 Department of Surgery, Cardiothoracic Unit, Usman Dan Fodio University Teaching Hospital, Sokoto, Nigeria
5 Department of Paediatrics, Federal Medical Centre, Nguru, Yobe State, Nigeria
6 Department of Paediatrics, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
Correspondence Address:
Dr. Ismail Mohammed Inuwa
Department of Surgery, Cardiothoracic Unit, Aminu Kano Teaching Hospital, Kano
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcls.jcls_24_19
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Introduction: The aim of this study is to highlight our experience in the management of long segment corrosive esophageal stricture using the left colon bypassing the strictured segment of the esophagus thereby maintaining continuity and restoring normal swallowing. Subjects and Methods: This was a retrospective study of patients with long-segment corrosive esophageal stricture who were managed by left colon bypass surgery in our center over a 5-year period between January 2012 and December 2016. Hospital records were reviewed and relevant information such as age, sex, clinical presentations, and operative procedure were obtained. The left colon grafts were taken under the pedicle of left colic artery in all cases, and three anastomoses were made at colocolic, cologastric, and colo-esophageal points. Feeding gastrostomy was done for all patients for early feeding. Results: There were 12 males (60%) and 8 females (40%) and age ranging from 2 years to 42 years; among them, there were 13 children (65%) and 7 adults (35%); caustic soda was the most common corrosive substance in 14 cases (70%) and acid in 2 cases (10%); the exact nature of the substances in 4 (20%) was not clear. Accidental ingestion was found in 90% of the cases. Psychiatric illness was associated in 2 adults (10%). Conclusion: The treatment of long segment corrosive esophageal stricture with left colon bypass graft surgery under the pedicle of the left colic artery is very effective with minimal postoperative complications; we, therefore, recommend this technique for relief of dysphasia from this form of injury.
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