Oesophageal resection with pharyngogastrostomy for corrosive stricture of pharynx and oesophagus

Abstract

A personal experience of 4 patients with combined pharyngeal and oesophageal stricture treated by total oesophagectomy with pharyngogastrostomy is reported. Postoperative recovery was smooth without any instance of anastomotic leakage and swallowing was restored. The major complication was recurrent dysphagia in the first 2 patients because of construction of too narrow an anastomosis, aggravated by postoperative scarring. Recurrent dysphagia did not occur during a 1-year follow-up in the subsequent 2 patients in whom a large pharyngogastrostomy anastomosis was established to the posterior pharyngeal wall. Minor tracheal aspiration occurred but even in the 2 patients with associated laryngeal injury, the symptoms subsided once swallowing was restored. Regurgitation was a problem only in one patient who developed gastric stasis; however, the symptoms subsided after pyloroplasty. Reconstruction of pharyngo-oesophageal stricture by pharyngogastrostomy restores almost normal swallowing provided that laryngeal function is adequate and a large pharyngogastrostomy anastomosis is established.