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KMID : 0364019970300010048
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Korean Journal of Thoracic and Cardiovascular Surgery
1997 Volume.30 No. 1 p.48 ~ p.54
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Esophageal Reconstruction for Hypopharyngeal Stricture After Severe Corrosive Injury
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변정욱
구본일/오상준/이홍섭/김창호/이신영
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Abstract
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Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Paik Hospital. There were 7 male and 4 female patients
aged
from 21 to 47 years(mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients.
The esophagus was reconstructed using the right colon in 9 and left colon in 2.
The cervical approach and the side of proximal anastomosis depended on the status of the pyriform sinus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were
divided
transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reveres triangular formed resection of the thyroid cartilage after elevation of perichondrium.
Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed.
There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in 3 patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one.
Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.
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KEYWORD
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