Docs reconstruct oesophagus using piece of colon at VIMS

NAGPUR: A 19-year-old girl who accidentally consumed acid, completely destroying her oesophagus, was unable to drink or eat. The oesophagus had become so constricted that she couldn’t even swallow her saliva. Doctors at Vidarbha Institute of Medical Sciences (VIMS) performed a rare surgery to correct the defect, and reconstructed the oesophagus using a portion of the .

The patient, who hails from Parasia, consumed the acid in April this year. She was treated by a local doctor, but gradually she developed dysphagia (inability to swallow food or water). She consulted Dr Rajesh Singhania at VIMS, who evaluated the patient and found that she had burned her oesophagus and that led to narrowing, which could not be treated with endoscopy. Since the patient needed some feeding urgently, first the doctors put her on a feeding tube from abdomen to the stomach so that she could take liquid food at least.

Dr Singhania then referred the patient to Dr Yogesh Bang, a gastroenterologist, for further management. Both decided to go for surgical intervention and replace her oesophagus with a part of the colon (end part of the digestive system).

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“Such injuries tend to progress and early surgery could be a failure, so we decided to wait for six months and let the damage stabilize,” said Dr Bang. After six months, Dr Singhania and Dr Bang performed the surgery, which is technically called as ‘colon interposition’. The patient can now drink and eat everything she likes.

Dr Bang explained that the oesophagus was created by cutting a piece of colon, about 45-50cm, lifting it up through the lower part of the digestive system to the neck via the chest cavity, and stitching it at the origin of the oesophagus. Now, this tube of colon will act as neo-oesophagus. Most important thing is this surgery maintains the blood supply to the colon.

“Generally, surgeons use a part of the stomach to replace the oesophagus. But this has many disadvantages. Since stomach secretes acid, the patient gets acidity in mouth. The feeling of hunger goes away when stomach is attached in the initial portion of the food pipe. Whereas colon is acid resistance, and maintains the feeling of hunger, and such surgery makes the patient feel normal,” explained Dr Bang.

Besides Dr Singhania and Dr Bang another surgical gastroenterologist Dr Yogendra Dadge from Latur and anaesthesiologist Dr Thakre supported the surgery.

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