Esophagocoloplasty for caustic stricture of the esophagus: changing concepts

A review of 540 patients with caustic esophageal stricture who underwent esophageal replacement over a 20 years period is presented. Their age at the time of esophagocoloplasty varied from 9 months to 18 years [mean 3.4 years]. Simple colon bypass of the strictured esophagus was performed in 455 patients utilizing the retrosternal route. Trans-hiatal esophagectomy with colon interposition was performed in the successive 85 patients. The overall mortality rate was 4.25%. 296 patients were available for periods between 1 and 20 years for evaluation. The isoperistaltic left colon is the best substitute for strictured esophagus in the experience. Prereconstruction feeding catheter gastrostomy is of utmost importance in most of the patients. Over the years, changes in technical measures to reduce colonic graft redundancy, esophagocolic anastomotic leak and stenosis, fear of malignant potentials and complications of left strictured esophagus have been learnt and are the subjects of this review

Posterior sagittal anorectoplasty for management of children with anorectal malfomation: applications and results

Over the past 5 years, 120 children with anorectal malformations [A.R.M] underwent their repair using the posterior sagittal approach. There were 112 primary cases and 8 redoes [following prior pull-through procedures]. fifty of our patients were males and 70 females. Their age at the time of procedure ranged from 3 months to 9 years, [mean 0.8 yr]. Eighty seven patients are now over 3 years of age and are available for evaluation regarding fecal continence. In our patients functional results of the procedure are found to be affected by the type of the original anomaly, sacral anatomy and the damage imposed by the previous repair in redo cases