Surgical Management of Severe Lye Burns of the Esophagus by Colon Interposition

Abstract

Thirty-seven patients with severe esophageal and hypopharyngeal burns from lye ingestion are reviewed. Preliminary surgical procedures consisting of gastrostomy, esophagostomy, esophagectomy, and tracheotomy were often performed prior to definitive esophageal bypass with colon interposition. The technical aspects of the two-team approach to colon interposition are described with particular emphasis placed on the cervical anastomosis. Common postoperative complications included aspiration, delayed tracheal decannulation, and restenosis in the anastomotic area. Functional restoration of deglutition and phonation was successful in most cases. Attention is focused on management of early and late complications. Results of colon transposition are discussed with references made to other surgical procedures. Functional evaluation of patients followed over a long period is described.