Surgical gastroenterologists from Nizam’s Institute of Medical Sciences (NIMS) here performed colonic interposition on a 40-year-old man from Jagtial, helping him to eat orally after more than two-and-a-half years.
In an oral cancer patient, his tongue and part of his jaw were previously removed. In addition, due to a trachea-esophageal fistula (abnormal connection between the food pipe and the air pipe), he had to undergo a tracheostomy (incision in the wind pipe) and was placed on Ryle’s tube feeding for more than two years. Those procedures were done in a corporate hospital.
The patient was then referred to the Department of Surgical Gastroenterology, NIMS for further management.
Although the team of doctors at NIMS performed more than 400 colonic interpositions, this was a complicated matter because radiotherapy had damaged the man’s esophagus and trachea, the food and air pipes were not connected properly, and some of the oral cavity The part was removed. ,
His aim was to disconnect an abnormal opening between his food pipe and air pipe, and rebuild the former with colonic interposition.
“Abnormal communication was identified and the windpipe was repaired. As the esophagus (food pipe) tissue was unhealthy with scarring, due to previous radiotherapy, the patient underwent colonic interposition, a major reconstructive procedure. This involves building a new groove using his large intestine, which runs from his abdomen through his chest to his neck, all the way to his mouth. It is a complex, skill-demanding surgery that requires a single artery with long conduit and at the base of the vein to preserve good blood supply,” said Head of Surgical Gastroenterology, N. Bhirappa said.
The operation was done free of cost under the Arogyashri Health Scheme. The patient is now able to feed orally. Over time, the tracheostomy will be removed which will also allow her to breathe and speak normally. He was discharged on Sunday.