Anaesthesia for Oesophageal Replacement with Colonconduit– A Review of Forty Six Cases

Abstract

This paper reviews the anaesthetic management of 46 adults with severe oesophageal burns replaced with colon conduit at the University ofNigeria TeachingHospital, EnuguNigeria over a 14 year period (Jan.1987 –Dec. 2000).
Aim: To highlight the common anaesthetic challenges in the management of oesophageal burns.
Methods: A retrospective review of all adult patients with corrosive burns of the oesophagus was made and the preoperative, intra-operative and postoperative anaesthetic care records were extracted and analyzed.
Result: Nine (19.5%) patients presented as emergency. Twelve (26%) patients required preoperative tracheostomy and the patients received feeding gastrostomy. Bradycardia occurred in all the patients during intestinalmobilization for the colon graft while tachycardia occurred during retrosternal tunneling of the colon conduit. Elective post-operative ventilationwas necessary in eleven (24%) patients whose pleura were breached during the procedure.
Conclusion: Care and protection of the airway and nutritional support are the main pre-operative challenges faced by the anaesthetist in the management of oesophageal burns. During the colon transplant surgery, adequate ventilation, volume replacement and control of arrhythmias are necessary for the success of the procedure.

Niger Med J. Vol. 49, No.3, July– Sept, 2008: 70 – 73.

Keywords: Oesophagus, Corrosive burns, colon graft, anaesthesia.