2025/09/28 by Adeoye, P. O., Agodirin, S. O., Ekpenyong, C. R. +6
#Esophageal disease #Esophageal resections #Jejunostomy #Transhiatal esophagectomy
paper · doi:10.82222/njcd.vol5no1.21
Introduction: Esophageal resections for both malignant and benign diseases are on the rise worldwide, highlighting the growing need for effective strategies in its surgical management which may be complex. The overall survival of patients post esophagectomy depends on multiple factors including the nature of the disease, comorbidities, age, and nutritional status of patients. There are few reports of indications and outcomes of this procedure in resource-constrained healthcare settings. Objective: To describe the indications, management, and outcomes of esophageal resection at the University of Ilorin Teaching Hospital (UITH), North Central Nigeria. Methods: A retrospective, descriptive study of patients who underwent esophageal resection in UITH over 10 years between January 2010 and December 2019. Results: Twenty-two (11 males and 11 females) patients had esophageal resection with an average age of 28 years. The most prevalent clinical presentation was grade 4 dysphagia, affecting nearly half (45.5%) of the patients. Benign esophageal diseases were the most common indication for esophagectomy with corrosive stricture accounting for 31.8% of cases. Nine patients (40.9%) had feeding jejunostomy, while 1 (4.5%) patient had a feeding gastrostomy pre-esophageal resection. Trans hiatal approach was the most commonly used approach (68% of cases), with the stomach utilized as the replacement option in all cases. Eighteen (81.8% of cases) patients were nursed in the postoperative period in the ICU for about 24 hours. The average intraoperative blood loss was 469ml. Two (9.1%) of the patients had anastomotic leak which was amenable to non-operative management. Three (13.6%) patients developed post-operative esophageal stenosis and had esophageal dilatation with improvement in functional outcome. Two (9.1%) male patients died within 30 days post-operation. Conclusion: Esophagectomy is more commonly performed for benign than malignant esophageal diseases in UITH. Transhiatal esophagectomy is a feasible and safe procedure in most of these patients with satisfactory outcomes. In our experience, the transhiatal route was more commonly used with the stomach as the replacement option of choice. However, it remains vital to individualize care for optimal outcomes.