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Title: Colopharyngoplasty for intractable caustic pharyngoesophageal strictures in an indigenous african community - adverse impact of concomitant tracheostomy on outcome
Authors: Tettey, M.
Edwin, F.
Aniteye, E.
Tamatey, M.
Mensah, K.E.
Ofosu-Appiah, E.
Frimpong-Boateng, K.
Keywords: EMTREE medical terms: adult; Africa; clinical article; colopharyngoplasty; dysphagia; esophagus stenosis; female; gastrotomy; human; indigenous people; laparotomy; male; outcome assessment; pharyngoesophageal stricture; pharynx disease; pharynx reconstruction; preoperative care; priority journal; respiratory tract disease; retrospective study; review; surgical technique; swallowing; tracheostomy; weight gain
MeSH: Adolescent; Adult; African Americans; Burns, Chemical; Caustics; Child; Child, Preschool; Cohort Studies; Colon; Esophageal Stenosis; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pharyngeal Diseases; Pharynx; Reconstructive Surgical Procedures; Retrospective Studies; Tracheostomy; Treatment Outcome; Young Adult
Issue Date: Feb-2001
Publisher: European Association for Cardio-Thoracic Surgery
Citation: Tettey, M., Edwin, F., Aniteye, E., Tamatey, M., Mensah, K. E., Ofosu-Appiah, E., & Frimpong-Boateng, K. (2011). Colopharyngoplasty for intractable caustic pharyngoesophageal strictures in an indigenous african community - adverse impact of concomitant tracheostomy on outcome. Interactive Cardiovascular and Thoracic Surgery, 12(2), 213-217
Abstract: Objective: Surgical management of caustic strictures of the upper digestive tract poses difficult challenges. This is because reconstruction above the cricopharyngeal junction interferes with the mechanisms of swallowing and respiration. This report reviews the outcome of colopharyngeal reconstruction of severe diffuse pharyngoesophageal caustic strictures in an indigenous African community. Method: The medical records of patients who underwent colopharyngoplasty from January 2006 to December 2008 were retrospectively reviewed to obtain information on patients' demographics, surgical technique and outcome. Results: In the study period, 20 patients underwent reconstruction for caustic esophageal strictures; in five (three males, two females) colopharyngoplasty was required. Their ages ranged from four to 56 years (mean 25 years). Follow-up ranged from 23 to 94 months (mean 33 months). Colopharyngoplasty using left colon tunneled retrosternally was performed in all patients. Rehabilitative training for deglutition was required for 0.5-5.0 months postoperatively to restore near-normal swallowing in all patients. However, tracheostomy complications caused two deaths (one early, one late) and varicella encephalitis caused another late death. Conclusion: In this African community, colopharyngoplasty provided an effective mean of restoration of upper digestive tract continuity in patients with severe caustic pharyngoesophageal strictures. Tracheostomy in this setting portends a significant long-term mortality risk
ISSN: 15699293
Appears in Collections:Department of Surgery 9
Department of Anaesthetics 9

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