DOI: http://dx.doi.org/10.18203/2349-2902.isj20203277

Iso-peristaltic colonic loop interposition for the treatment of benign oesophageal stricture: a case report with review of literature

Pradeep Balineni, Venkata Pavan Kumar C., Debaraju Reddy E.

Abstract


Corrosive oesophageal strictures are a common and debilitating condition in India. Patients generally have dysphagia, cachexia, drooling of saliva, aspiration pneumonitis, and lung abscess. Though endoscopic dilatations are done in cases of short segment strictures, surgical oesophageal by pass is the permanent solution for this condition. A 24 years female presented with complaints of dysphagia and cachexia, due to corrosive stricture. Patient had a history of poison ingestion 2 years back. Intra-operatively stricturous mucosa is excised and an iso peristaltic colonic loop by pass was carried out. Post operatively patient had a complication of anastomotic leak which was treated conservatively, excepting which patient is symptom free and gaining weight on a follow up period of 1 year. Ever since first described by Kelling and Vuillet in 1911 colonic interposition is mostly used around the globe for oesophageal bypass in both benign and malignant conditions. Stomach and jejunum are the other conduits that can be used. Iso peristaltic loop is mostly used to reduce the incidence of reflux. Right colon or transverse colon graft based on the mid colic artery or the left colic artery owing to the reliable blood supply and less diameter. This procedure has a high complication rate of around 27% most of which are due to the vascular comprise of the graft.


Keywords


Corrosive strictures, Oesophageal bypass, Colonic interposition, Iso-peristaltic loop, Dysphagia

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References


Sharma P, Pancholi M. Colon interposition in the treatment of corrosive esophageal strictures: 100 patients in seven years. Int Surg J. 2019;6(10):3727-32.

Gvalani AK, Deolekar S, Gandhi J, Dalvi A. Antesternal colonic interposition for corrosive esophageal stricture. Indian J Surg. 2014;76(1):56-60.

Furst H, Hartl WH, Lohe F, Schildberg FW. Colon interposition for esophageal replacement: an alternative technique based on the use of the right colon. Ann Surg. 2000;231(2):173‐8.

Spitali C, Vogelaere KD, Delvaux G. Dysphagia after colon interposition graft for esophageal carcinoma. Case Reports Pathology. 2012;5:738205.

Eze JC, Onyekwulu FA, Nwafor IA, Etukokwn K, Orakwe O. Right colon interposition in corrosive esophageal long segment stricture: our local experience. Niger J Clin Pract. 2014;17(3):314‐9.

Reddy JR, Shenoy G, Shetty N, Gururajarao M, Gadiyaram S. Supercharged colonic interposition for corrosive pharyngo-esophageal stricture. Trop Gastroenterol. 2015;36(3):192‐5.

Jeyasingham K, Lerut T, Belsey RHR. Functional and mechanical sequelae of colon interposition for benign oesophageal disease. European J Cardio-thoracic Surg. 1999;15(3):327-32.

Chen Q, Mao W, Yu H, Liang Y, Wang J, Chen G. Application of colon interposition among the esophageal cancer patients with partial gastrectomy. J Cancer Res Ther. 2016;12:212‐6.

Heinrich F, Hartl WH, Florian L, Schildberg FW. Right colon interposition for esophageal replacement rice T. W. operative techniques in thoracic and cardiovascular surgery. Ann Surg. 1999;4 (3):210-21.

Tom RD. Esophageal replacement with colon interposition. Operative Techniques Cardiac Thoracic Surg. 1997;2(1):3-86.

Postlethwait RW, Sealy WC, Dillon ML, Young AG. Colon interposition for esophageal substitution. Annals Thoracic Surg. 1971;12(1):89-109.