TRANSHIATAL ESOPHAGECTOMY FOR BENIGN OBSTRUCTIVE CONDITIONS OF THE ESOPHAGUS

Background Transhiatal oesophagectomy is an accepted approach for the treatment of carcinoma of the oesophagus. However, experience of this technique in benign diseases is limited. Methods Transhiatal oesophage ctomy was done in 29 patients for benign oesophageal conditions includ ing corrosive stricture (21),achalasia of the cardia (four), tuberculo sis (one), mediastinal fibrosis (one), Crohn's disease (one) and pepti c stricture (one). Dysphagia was the predominant symptom in all patien ts; strictures had all previously been dilated repeatedly. The stomach was used as an oesophageal substitute in 24 patients in five with a s carred stomach due to damage by a corrosive agent, oesophagocoloplasty was performed. Resection and reconstruction were done in one stage in 25 patients; four with poor nutritional status had a two-stage proced ure. Results There was no perioperative death. Complications encounter ed were recurrent laryngeal nerve palsy (six patients) which was mostl y transient. anastomotic leak (seven) and stenosis (eight). Postoperat ive function of the intrathoracic stomach was satisfactory. Conclusion Transhiatal oesophagectomy is a safe and satisfactory procedure for b enign obstructive conditions of the oesophagus.