Is it necessary to resect the diseased esophagus in performing reconstruction for corrosive esophageal stricture?

Objective: The incidence of carcinoma of the esophagus among patients with chronic esophageal stricture caused by ingestion of corrosive agents is rep orted to be significantly higher than that of the general population. The q uestion of whether or not a resection of the diseased esophagus should be i ncluded in the surgical reconstruction procedure of the undilatable esophag eal stricture continues to be a controversial. Methods: During the 12 year period from 1988 to 1999, a total of 54 consecutive patients with caustic s tricture of the esophagous were treated in our department. We retrospective ly reviewed these cases and analyzed the incidence of cicatrical carcinoma among the patients and the risk of esophagectomy according to the procedure s performed. Results: We found seven cases of esophageal cancer among these patients. There was no significant increase in mortality or morbidity rela ted to esophagectomy. Conclusions: Considering the high incidence of cicatr ical carcinoma from the stricture sites as well as the possible chance of h idden malignancy, we concluded that the simultaneous resection of the esoph agus with reconstruction for patients with chronic intractable caustic stri cture would give the patients a better probability of being completely cure d of the disease. (C) 2001 Elsevier Science B.V. All rights reserved.