• Mark Tettey, Frank Edwin, Ernest Aniteye, Martin Tamatey, Kow Entsua-Mensah, Ernest Ofosu-Appiah, and Kwabena Frimpong-Boateng.
• National Cardiothoracic Centre, Korle Bu Teaching Hospital, Box KB 846 Korle Bu, Accra. Ghana. mawut@mail.com
• Interact Cardiovasc Thorac Surg. 2011 Feb 1; 12 (2): 213-7.

ObjectivesSurgical management of caustic strictures of the upper digestive tract poses difficult challenges. This is because reconstruction above the cricopharyngeal junction interferes with the mechanisms of swallowing and respiration. This report reviews the outcome of colopharyngeal reconstruction of severe diffuse pharyngoesophageal caustic strictures in an indigenous African community.MethodThe medical records of patients who underwent colopharyngoplasty from January 2006 to December 2008 were retrospectively reviewed to obtain information on patients' demographics, surgical technique and outcome.ResultsIn the study period, 20 patients underwent reconstruction for caustic esophageal strictures; in five (three males, two females) colopharyngoplasty was required. Their ages ranged from four to 56 years (mean 25 years). Follow-up ranged from 23 to 94 months (mean 33 months). Colopharyngoplasty using left colon tunneled retrosternally was performed in all patients. Rehabilitative training for deglutition was required for 0.5-5.0 months postoperatively to restore near-normal swallowing in all patients. However, tracheostomy complications caused two deaths (one early, one late) and varicella encephalitis caused another late death.ConclusionIn this African community, colopharyngoplasty provided an effective mean of restoration of upper digestive tract continuity in patients with severe caustic pharyngoesophageal strictures. Tracheostomy in this setting portends a significant long-term mortality risk.

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