Colopharyngoplasty in the Treatment of Postcorrosive Stricture of Swallowing Tract

Czech version

Authors: J. Sýba ¹; L. Mrázková ³; M. Hrušková ³; I. Bártová ⁴; M. Zábrodský ¹; A. Kešner ¹; L. Dostálová ¹; T. Haruštiak ²; R. Lischke ²; J. Plzák ¹
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku, 1. LF UK a FN v Motole, Katedra otorinolaryngologie IPVZ, Praha ¹; III. chirurgická klinika 1. LF UK a FN v Motole, Praha ²; Klinika rehabilitace a tělovýchovného lékařství, 2. LF UK a FN v Motole, Praha ³; Klinika otorinolaryngologie a chirurgie hlavy a krku, Nemocnice pardubického kraje a. s., Pardubická nemocnice, Pardubice ⁴
Published in: Otorinolaryngol Foniatr, 68, 2019, No. 3, pp. 161-165.
Category: Case Reports

Overview

Postcorrosive strictures of the upper aerodigestive tract are serious complications of caustic injury. In case of development of extensive strictures or necrosis, it is usually necessary to perform a resection of the damaged part of the digestive tract with a restoration of the continuity of the swallowing pathways by autologous material. Simultaneous involvement of the hypopharynx and esophagus makes subsequent treatment very difficult, because the reconstruction of this area interferes with swallowing and breathing. If the replacement is required, it is technically easier to perform total laryngectomy and resection of the affected part of the swallowing tract with subsequent reconstruction. Morbidity associated with total laryngectomy is generally unacceptable for patients without corrosive laryngeal injury. Therefore, the technique of colopharyngoplasty has been developed. A 35 years old patient swallowed hydrochloric acid in a suicidal attempt. Esophagectomy with cervical esophagostomy and total gastrectomy was performed urgently. The patient was indicated for delayed reconstruction of the swallowing tract. Due to the fully preserved larynx, reconstruction of the hypopharynx and esophagus was performed by colopharyngoplasty technique without laryngeal resection. After intensive rehabilitation of voice and swallowing, successful decannulation was performed and full oral intake was restored.

Keywords:

dysphagia – colopharyngoplasty – pharyngoesofageal stricture – acid burn – caustic injury

Sources

1. Benjamin, B., Agueb, R., Vuarnesson, H. et al.: Tracheobronchial necrosis after caustic ingestion. Ann Surg, 263, 2016, 4, s. 808-813.

2. Hopkins, R. A., Postlethwait, R. W.: Caustic burns and carcinoma of the esophagus. Ann Surg, 194, 1981, 2, s. 146-148.

3. Chirica, M., Brette, M. D., Faron, M. et al.: Upper digestive tract reconstruction for caustic injuries. Ann Surg, 261, 2015, 5, s. 894-901.

4. Chirica, M., de Chaisemartin, C., Goasguen, N. et al.: Colopharyngoplasty for the treatment of severe pharyngoesophageal caustic injuries: an audit of 58 patients. Ann Surg, 246, 2007, 5, s. 721-727.

5. Chirica, M., Veyrie, N., Munoz-Bongrand, N. et al.: Late morbidity after colon interposition for corrosive esophageal injury: risk factors, management, and outcome. A 20-years experience. Ann Surg, 252, 2010, 2, s. 271-280.

6. Choi, R. S., Lillehei, C. W., Lund, D. P. et al.: Esophageal replacement in children who have caustic pharyngoesophageal strictures. J Pediatr Surg, 32, 1997, 7, s. 1083-1087; discussion 1087-1088.

7. Popovici, Z., Marinescu, A.: Total „pharyngoplastia vera“ with the colon in caustic pharyngo-laryngeal stenoses. Ann Otolaryngol Chir Cervicofac, 102, 1985, 5, s. 311-315.

8. Rosenbek, J. C., Robbins, J. A., Roecker, E. B. et al.: A penetration-aspiration scale. Dysphagia, 11, 1996, 2, s. 93-98.

9. Tettey, M., Edwin, F., Aniteye, E. et al.: Colopharyngoplasty for intractable caustic pharyngoesophageal strictures in an indigenous African community--adverse impact of concomitant tracheostomy on outcome. Interact Cardiovasc Thorac Surg, 12, 2011, 2, s. 213-217.

10. Urbanová, G., Gernertová, L., Katra, R. et al.: Poleptanie pažeráka diskovitou batériou u detí. Otorinolaryng a Foniat /Prague/, 64, 2015, s. 87-92.

11. Zangi, M., Saghebi, S. R., Biharas Monfared, A. et al.: Colopharyngoplasty in Patients with Severe Pharyngoesophageal Corrosive Injury: A Complicated but Worthwhile Procedure to Restore GI Tract Continuity, A Case Series. Tanaffos, 16, 2017, 1, s. 68-75.