Abstract
Abstract
Background:
Corrosive ingestion leads to severe esophageal injury, often resulting in long-segment strictures requiring surgical reconstruction. When the stomach is unsuitable, colonic interposition (coloplasty) serves as an effective alternative. However, long-term functional outcomes and conduit-related complications remain underreported.
Aim:
The aim is to evaluate the long-term functional outcomes and complications of colon conduit following surgical management of corrosive esophageal strictures.
Materials and Methods:
This retrospective observational study was conducted at the Department of Surgical Gastroenterology, NIMS, Hyderabad. Twenty patients who underwent colonic interposition for corrosive esophageal strictures between 2007 and 2012 with at least one-year follow-up were included. Patients were evaluated using clinical assessment, barium swallow, radionuclide transit study, contrast-enhanced CT chest, endoscopy with biopsy, and esophageal manometry. Statistical analysis was performed using descriptive and inferential methods with 95% confidence intervals.
Results:
The study included 20 patients (50% of males, 50% of females) with a mean age of 23 years. Suicidal ingestion was the predominant cause (90%). All patients (100%) showed satisfactory weight gain. Reflux was observed in 5% of cases and was managed conservatively. Barium studies revealed cervical anastomotic stricture and redundant conduit in 5% each. Radionuclide studies showed normal liquid transit in all patients, while 20% demonstrated delayed solid transit. Endoscopy showed normal mucosa in all patients, with mild inflammatory changes in 10% on biopsy. No evidence of malignancy or mucocele was detected on imaging. Manometry revealed hypotensive peristalsis with low-amplitude waves (10-12 mmHg) in all patients.
Conclusion:
Colonic interposition provides favorable long-term functional outcomes with minimal morbidity in patients with corrosive esophageal strictures. Although complications such as anastomotic stricture, reflux, and delayed transit may occur, they are generally manageable. Regular long-term surveillance is essential to detect potential conduit-related changes and ensure optimal patient outcomes.