TY  - JOUR
PY  - 2014//
TI  - Upper digestive tract reconstruction for caustic injuries
JO  - Annals of surgery
A1  - Chirica, Mircéa
A1  - Brette, Marie-Dominique
A1  - Faron, Matthieu
A1  - Bongrand, Nicolas Munoz
A1  - Halimi, Bruno
A1  - Laborde, Christine
A1  - Sarfati, Emile
A1  - Cattan, Pierre
SP  - 894
EP  - 901
VL  - 261
IS  - 5
N2  - OBJECTIVE:: The aim of the study was to compare the short- and long-term outcomes of colopharyngoplasty and esophagocoloplasty for caustic injuries of the upper digestive tract. <br><br>BACKGROUND:: Simultaneous esophageal and pharyngeal reconstruction by colopharyngoplasty allows regaining nutritional autonomy in patients with severe pharyngoesophageal caustic injuries. <br><br>METHODS:: Patients who underwent upper digestive tract reconstruction for caustic injuries by colopharyngoplasty (n = 116) and esophagocoloplasty (n = 122) between 1993 and 2012 were included. Survival and functional outcomes were analyzed. Success was defined as nutritional autonomy after removal of the jejunostomy and tracheotomy tubes. Quality of life was assessed using the QLQ-OG25 and SF12v2 questionnaires. <br><br>RESULTS:: Overall Kaplan-Meyer survival at 1, 5, and 10 years after colopharyngoplasty and esophagocoloplasty were 92%, 74%, 67% and 92%, 83%, 73%, respectively (P = 0.56). Quality of life and functional results (success: 57% vs 95%, P < 0.0001) were impaired after colopharyngoplasty. On multivariate analysis, older age (OR: 0.94; CI: 0.91-0.97, P < 0.0001) and pharyngeal reconstruction (OR: 0.05; CI: 0.02-0.13, P < 0.0001) were associated with failure. The decline in success with age was more pronounced after colopharyngoplasty with only 1 (7%) of 15 patients operated after the age of 55 being self-sufficient for eating and breathing. Laryngeal resection during colopharyngoplasty had no influence on success (54% vs 58%, P = 0.67) CONCLUSIONS:: The need to associate pharyngeal reconstruction during esophageal reconstruction for caustic injuries has a long-term negative impact on functional outcome.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4932
UR  - http://dx.doi.org/10.1097/SLA.0000000000000718
ID  - ref1
ER  -