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[Staged oesophageal reconstruction for benign disease]. | LitMetric

Objectives: To assess morbidity, mortality and quality of life after oesophageal reconstruction in patients with oesophageal exclusion for benign diseases.

Patients And Methods: From 2002 to 2011, 20 of 24 patients with esophageal exclusion due to benign disease underwent a delayed reconstruction. We analyzed morbidity, mortality and health-related quality of life using the SF-36 questionnaire, before and after reconstruction.

Results: Twenty patients were operated (16 men and 4 women) with an average age of 54.5 ± 10.5 years. Main causes of oesophageal disconnection were: 10 cases of caustics ingestion, 3 iatrogenic perforations, 4 anastomotic leaks and 3 cases with Boerhaave syndrome. Fourteen (60%) coloplasties and 6 (25%) gastric interpositions were performed with an average time of 212,2 ± 23.5 days after oesophageal exclusion. Pulmonary complications were the most common postoperative complications (55% patients) and according to the modified Clavien classification were divided into: grade 1 (10%), grade 2 (15%), grade 3a (40%), grade 3b (10%), and grade 4a (10%). The 30-day mortality (grade 5) of the series was 10%. Quality of life after reconstruction improved significantly in all analyzed domains of the SF-36 questionnaire.

Conclusions: Deferred oesophageal reconstruction is associated with a high morbidity and a mortality rate of 10%. After reconstruction, the quality of life improved in all the parameters evaluated.

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http://dx.doi.org/10.1016/j.ciresp.2012.03.010DOI Listing

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