The experience of surgical treatment of the patients with extended cicatricial esophageal strictures

Abstract

The aim of the researce was the improvement of treatment results of patients with extended post-burn esophageal cicatricial strictures. Materials and methods: The treatment results are presented for 102 patients which were divided into two groups. In 49 patients with extended post-burn esophageal cicatricial strictures of the main group modified esophagoplasty were performed. Traditional esophagoplasty in 53 patients of the comparison group was performed. Results: A trend was observed on reduction in both short-term and long-term post-operative complications and lethality. The comparative analysis showed statistically valid reduction in number of complications caused by radical surgery: in the main group the frequency of short-term post-operative complications was 10,2 %, in the comparison group – 45,3 %, the frequency of long-term post-operative complications being in the main group 8,2 %, and in the comparison group 26,4%. A trend was observed on reduction of both local and general complications, which may be explained by both peculiarities of the operative interventions with application of improved surgical treatment methods and by more efficient pre-operation preparation of the patients. Post-operative lethality level was 2,0 % in the main group, and 3,8% in the comparison group. Life quality parameters in the main group patients in the long-term post-operation period were statistically significantly better. Conclusions: In patients with extended post-burn esophageal cicatricial stricture application of the proposed surgical tactics, modified method of single-step esophagoplasty and esophagoplasty as Step II of the surgical treatment for persons who have a formed contact gastrostomy is an efficient means for patients’ treatment improvement.