Two-Point Fixation Technique in Retrosternal Midcolon Interposition for Corrosive Stricture of Esophagus-Our Experience With 25 Patients. 2020

Praveen Sharma, and Mukesh Pancholi
Department of Surgery, Government Medical College, India.

Background. In 1911, Vuillet and Kelling independently described the anatomical and surgical bases of esophageal replacement with the colon. An important complication, in particular in later follow-up, is redundancy of the interposed colon, seen more after retrosternal interposition. The best treatment is prevention by a meticulous surgical technique and measurement of the length of the colon needed to replace the esophagus. Methods. This was a retrospective study of innovative surgical technique. A total of 25 patients with corrosive stricture of the esophagus undergoing two-point fixation in retrosternal colon interposition were included in the study. Preventive Operative Technique. After straightening of conduit by pulling very delicately over both sides, first fixation point we considered cervical anastomoses and second fixation point was made in subxiphoid space, taking two seromuscular stiches from the antimesenteric border of the colon to falciform ligament situated on the right side of the conduit. Results. There were 07 male and 18 female patients with M:F was 1:2.5; mean age was 29 years (range: 23-45 years) and mean hospital stay was 14 days (range: 10-23 days). In this study, we did not encounter any subjective or objective evidence of redundancy in any patients in follow-up barium swallow after 2.5 years of follow-up. Conclusion. Our Two-point fixation technique is refinement of already performed and tried fixation techniques to prevent redundancy of the colon conduit considering kinetics, anatomical alignment, and pathology.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002057 Burns, Chemical Burns caused by contact with or exposure to CAUSTICS or strong ACIDS. Chemical Burns,Burn, Chemical,Chemical Burn
D002424 Caustics Strong alkaline chemicals that destroy soft body tissues resulting in a deep, penetrating type of burn, in contrast to corrosives, that result in a more superficial type of damage via chemical means or inflammation. Caustics are usually hydroxides of light metals. SODIUM HYDROXIDE and potassium hydroxide are the most widely used caustic agents in industry. Medically, they have been used externally to remove diseased or dead tissues and destroy warts and small tumors. The accidental ingestion of products (household and industrial) containing caustic ingredients results in thousands of injuries per year. Caustic,Corrosive,Corrosives
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D003251 Constriction, Pathologic The condition of an anatomical structure's being constricted beyond normal dimensions. Stenosis,Stricture,Constriction, Pathological,Pathologic Constriction,Constrictions, Pathologic,Pathologic Constrictions,Pathological Constriction,Stenoses,Strictures
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Praveen Sharma, and Mukesh Pancholi
November 2012, Surgical endoscopy,
Praveen Sharma, and Mukesh Pancholi
January 2014, Nigerian journal of clinical practice,
Praveen Sharma, and Mukesh Pancholi
June 2019, Current medical science,
Praveen Sharma, and Mukesh Pancholi
February 2014, The Indian journal of surgery,
Praveen Sharma, and Mukesh Pancholi
January 2015, Tropical gastroenterology : official journal of the Digestive Diseases Foundation,
Praveen Sharma, and Mukesh Pancholi
January 1986, Acta chirurgica Iugoslavica,
Praveen Sharma, and Mukesh Pancholi
January 2005, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology,
Praveen Sharma, and Mukesh Pancholi
September 2014, World journal of surgery,
Praveen Sharma, and Mukesh Pancholi
July 1995, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology,
Praveen Sharma, and Mukesh Pancholi
January 1992, The Annals of thoracic surgery,
Copied contents to your clipboard!