Corrosive pharyngoesophageal stricture – A challenge to surgeon: A tertiary center experience

Abstract

Background: Pharyngoesophageal stricture with laryngeal involvement due to corrosive ingestion is rare, and limited literature is available regarding management. Outcome is unpredictable due to progressive scaring of anastomosis and associated respiratory complications. Here, we share our experience of managing this challenging entity. Materials and Methods: Of 57 corrosive ingestion patients, we reviewed 15 patients of isolated pharyngoesophageal stricture managed in our unit of a tertiary care center between 2008 and 2016. The medical records, initial management, operative data, postoperative course, and follow-up data of these 15 patients were reviewed. These 15 patients divided into Group A of endless string insertion and dilatation and Group B of five patients who underwent additional colonic interposition. Results: Of 15 patients, 10 patients belonged to Group A of endless string insertion and dilatation and five patients belonged to Group B with additional coloplasty. All the 10 patients were successfully dilated with endless string insertion, whereas in coloplasty group, four patients out of five are taking normal diet, and one patient succumbed due to nonoperative cause. All 15 patients had no respiratory complication postoperatively, and five patients who were on tracheostomy before surgery are weaned off completely. All 14 patients have no dysphagia, have no respiratory complications, and have gained weight. Conclusion: Severe upper aerodigestive injury is rare and its management is herculean task, but satisfactory functional reconstruction can be achieved in the majority of patients without the need for permanent tracheostomy or feeding jejunostomy by our technique giving good quality of life.