Annals of Surgery

Skip Navigation LinksHome > May 2015 - Volume 261 - Issue 5 > Upper Digestive Tract Reconstruction for Caustic Injuries
Annals of Surgery:
doi: 10.1097/SLA.0000000000000718
Original Articles

Upper Digestive Tract Reconstruction for Caustic Injuries

Chirica, Mircea MD*; Brette, Marie-Dominique MD; Faron, Matthieu MD*; Munoz Bongrand, Nicolas MD*; Halimi, Bruno MD*; Laborde, Christine RN*; Sarfati, Emile MD*; Cattan, Pierre MD, PhD*

Collapse Box


Objective: The aim of the study was to compare the short- and long-term outcomes of colopharyngoplasty and esophagocoloplasty for caustic injuries of the upper digestive tract.

Background: Simultaneous esophageal and pharyngeal reconstruction by colopharyngoplasty allows regaining nutritional autonomy in patients with severe pharyngoesophageal caustic injuries.

Methods: Patients who underwent upper digestive tract reconstruction for caustic injuries by colopharyngoplasty (n = 116) and esophagocoloplasty (n = 122) between 1993 and 2012 were included. Survival and functional outcomes were analyzed. Success was defined as nutritional autonomy after removal of the jejunostomy and tracheotomy tubes. Quality of life was assessed using the QLQ-OG25 and SF12v2 questionnaires.

Results: Overall Kaplan-Meyer survival at 1, 5, and 10 years after colopharyngoplasty and esophagocoloplasty were 92%, 74%, 67% and 92%, 83%, 73%, respectively (P = 0.56). Quality of life and functional results (success: 57% vs 95%, P < 0.0001) were impaired after colopharyngoplasty. On multivariate analysis, older age (odds ratio [OR]: 0.94; confidence interval [CI]: 0.91–0.97 P < 0.0001) and pharyngeal reconstruction (OR: 0.05; CI: 0.02–0.13, P < 0.0001) were associated with failure. The decline in success with age was more pronounced after colopharyngoplasty with only 1 (7%) of 15 patients operated after the age of 55 being self-sufficient for eating and breathing. Laryngeal resection during colopharyngoplasty had no influence on success (54% vs 58%, P = 0.67)

Conclusions: The need to associate pharyngeal reconstruction during esophageal reconstruction for caustic injuries has a long-term negative impact on functional outcome.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.