Transoral stapled pharyngogastroplasty following gastric pull-up in pharyngo-oesophageal strictures: a case series

Corrosive pharyngo-oesophageal stricture is now one of the rarer diseases of the oesophagus. In patients with non-dilatable or post-failed dilation corrosive pharynx-oesophageal strictures, the surgical options are varied as surgeons strive to preserve both swallowing and breathing mechanisms whilst reducing the risks of aspiration. In this case series, we describe our surgical approach to dealing with this disease entity and its outcomes. This is a case series of 6 patients who underwent our transoral stapled pharyngogastroplasty for corrosive pharyngo-oesophageal strictures within the last 10 years. In this paper, we discuss our surgical technique of transhiatal oesophagectomy combined with a transoral stapled pharyngogastric anastomosis as well as their outcomes. All six patients underwent the surgical procedure. Four of the patients required an additional 1 or 2 sessions of dilation in their follow-up period. One patient suffered from persistent aspiration post operatively due to a diseased larynx and required a tracheostomy and jejunostomy feeding. There was no in-hospital mortality. Transhiatal stapled pharyngogastroplasty is an option in the management of this disease entity, and surgeons may add it to their armamentarium. A discussion with the patient about the potential need for dilation at some point in the future should be held.