Abstract
Background:
Studies comparing the long-term outcomes of colonic interposition versus gastric conduit reconstruction are lacking. Hence, we analyzed the long-term and short-term outcomes and quality of life (QOL) of patients with corrosive esophageal stricture (CES) who underwent either colon or gastric conduit reconstruction at our institution in the past.
Methods:
Patients of CES who underwent surgery at our institution and were eligible for at least 5 years of follow-up were included in the study. Symptoms, alimentary satisfaction, and QOL were assessed through telephonic interviews, questionnaires (WHO BREF, SF-36), and in-person assessments.
Results:
56 patients underwent surgery (esophageal resection = 29; bypass = 27) and reconstruction with either colon (18) or gastric conduit (38). Short-term results (complications) were comparable in resection versus bypass and between colon versus gastric conduit reconstruction groups. The most common procedure-related complications were pulmonary (18%). Long-term outcomes were assessed in 29 patients available for long-term follow-up (Colon-14 vs gastric-15). These groups were comparable in terms of demographics and resection versus bypass. Median follow-up was 112 months (IQR, 79-140) (colon conduit, 127 months; gastric conduit, 104 months). We found no difference in the QOL. Overall, 86% of patients were free of dysphagia and regurgitation (similar in both groups). Alimentary satisfaction scores were also comparable, 9 and 8.7 (P = 0.91).
Conclusion:
Long-term QOL and alimentary satisfaction were excellent and comparable after both reconstructions. Considering the inherent complexity of colonic interposition, a gastric conduit may be preferred when a healthy stomach is available for reconstruction in these patients.
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