Articles

Purpose : To describe the surgical aspects of the managing of caustic oesophageal stenosis, in the Thoracic and Viseral Surgery Units of the University Hospital of Antananarivo Madagascar.
Methods : It is a prospective descriptive study, about 3 years from January the 1st 2014 till December the 31st 2016, including each case’s first year evolution. Were included all patients at least 15 years old, having be operated for œsophageal caustic stenosis. The mean of the postoperative surveillances was 22.09 months.
Results : Eleven patients were colliged. The sex ratio was 4.5. Median of ages was 37 years old. The caustic burn was volontary in 8 patients. Acid was the most incriminated substance. Oesophagectomy with oesophageal coloplasty in retrosternal without thoracotomy was performed in 9 patients and by thoracotomy to 2 others.
Were noted in postoperative : 2 cases of stenotic reccurence, 2 deaths and one case of cervical anastomotic fistula requiring revision.
Conclusion : The caustic oesophageal stenosis increase their incidences in Madagascar. Surgery is heavy and invasive but it remains the main option till endoscopic dilatation is not available. The postoperative results is often precarious because of prolonged delay of the curative surgery in the nonpermissive economic local context.