THORACO-LAPAROSCOPIC ESOPHAGECTOMY FOR POST-BURN ESOPHAGAL STRICTURES toktogaziev_bakyt@mail.ru

 

THORACO-LAPAROSCOPIC ESOPHAGECTOMY FOR POST-BURN ESOPHAGAL STRICTURES

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Kyrgyzstan

Oral only

Caustic esophageal strictures remain a significant global surgical challenge. Despite advancements in minimally invasive techniques, patients with long-segment (>3 cm) strictures continue to require radical surgical intervention. Recent literature (Hu et al., 2023; Singh et al., 2024) highlights the growing role of thoraco-laparoscopic esophagectomy due to its reduced invasiveness, lower complication rates, and faster recovery. In Kyrgyzstan, there has been a steady annual increase in patients with caustic strictures, largely due to rising household ingestion of corrosive substances.

From 2018 to 2024, 130 patients underwent thoraco-laparoscopic esophagectomy for caustic esophageal strictures. The cohort included 67% females and 33% males, aged between 18 and 72 years. A total of 87 patients had previously undergone gastrostomy. In 38% of cases, feeding enterostomies were intraoperatively placed due to preoperative nutritional deficiencies, ensuring early postoperative enteral support. On the fifth postoperative day, contrast esophagography was routinely performed, followed by initiation of oral feeding.

Postoperative mortality was 2.3% (3 patients): one case of postoperative asphyxia, one pulmonary embolism, and one due to multi-organ failure. Anastomotic strictures occurred in 6 patients (4.6%) within 1–1.5 months and were successfully managed endoscopically with bougienage. A majority have resumed oral feeding, significantly improving their quality of life and social reintegration.

Thoraco-laparoscopic esophagectomy is a reliable surgical solution for caustic esophageal strictures over 3 cm. In patients with prior. Preoperative optimization, including enterostomy placement when needed, is essential for minimizing complications and facilitating recovery.