[The second reconstructive operation of the esophagus]. / Ponowne operacje wytwórcze przelyków z uszypulowanych przeszczepów jelitowych.

What we need in order to obtain good results in oesophageal reconstructive surgery is long enough segment of intestine with sufficient blood supply. Evaluation of the blood flow is very difficult and often only after completion of the mobilization and transposition of the intestine into the neck final evaluation can be made. In the cases with poor blood flow one must resign from the already mobilized intestine. In such situation the second operation with the use of different alimentary tract segment must be performed. In our practice we encountered 7 cases where it was necessary to mobilize the second intestinal segment in order to achieve success in the reconstruction of the oesophagus. In 3 cases during the first operation jejunum was used. In 3 cases the necrosis of mobilized jejunal segment forced us to perform the second operation. In two patients during the second operation right colon segment along with terminal ileum was used. The third was operated with the use of right colon. In 2 others right colon was used in the first operation. One of them was operated for the second time with the use of left colon. The other were operated with the use of ileum. 2 patients with the substitute from right colon along with the terminal ileum when operated for the second time had the jejunum and left colon segment used to bridge the gap. Mortality in our reconstructive operations was 28.57% (2/7).

[Iatrogenic esophageal injuries]. / Jatrogenne uszkodzenia przelyku.

Own experience regarding treatment of 25 iatrogenic oesophageal lesion are discussed. Diagnosis was established mainly by x-ray examination with the water soluble contrast and plain chest x-ray. One patient was treated conservatively. 24 were operated. All patients received antibiotics intravenously and for local mouth rinse. Operations consists of chest drainage and exclusion of oesophagus from food passage by gastrostomy. Treatment in all cases resulted in healing of oesophageal lesion.