ArticleInternational journal of surgery case reports2021
Case report on thoracoscopic esophagectomy for long segment resistant oesophageal stricture in HIV infected patient.
Article in International journal of surgery case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed, 1 citations in OpenAlex.
- Robot-assisted oesophagectomy (Ivor-Lewis) for a complex stenosis previously managed by open gastrostomy tube placement.BMJ case reports · 2024Article
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2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of Esophageal strictures following esophagitis in human immunodeficiency virus (HIV)-infected patients is profound in majority of cases. Although endoscopic dilatation remains the first line of treatment, surgery is needed for non-dilatable strictures. Sparse literature is available on clinical management for surgical intervention. PRESNTATION OF THE CASE: A 30 years old HIV positive male, taking ART for 10 years, presented with grade V dysphagia over long standing non-specific ulcerative esophagitis. Upper GI endoscopy revealed a long stricture starting 18 cm from the incisors. The patient underwent multiple endoscopic dilatation along with twice endoscopic stent placements over period of 2 years. As CD4 count was low associated with poor nutritional status a feeding jejunostomy was constructed. With improvement in CD4 count and nutritional status within 3 months; thoracoscopic esophagectomy, laparotomy and formation of gastric conduit and cervical anastomosis was performed. There were no intraoperative or postoperative adverse events with complete improvement in dysphagia. During follow up, 24 months after surgery the patient was on full oral diet with a total weight gain of 15 kg. DISCUSSION: Long term solution to dysphagia due to long esophageal stricture merits a surgery in form of a replacement conduit by either stomach tube or a segment of colon. Experience and literature guiding surgical decision making are limited. Retaining or excision of the native oesophagus is still a matter of discussion.
conclusionThoracoscopic esophagectomy with gastric tube conduit for reconstruction is a feasible and safe surgical option for esophageal stricture in a HIV infected patient.
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