Surgical gastroenterologists at the Nizam’s Institute of Medical Sciences (NIMS) here performed colonic interposition on a 40-year-old man from Jagtial, helping him consume food orally after over two-and-a-half years.
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An oral cancer patient, a part of his tongue and jaw had earlier been removed. Besides, due to trachea-esophageal fistula (abnormal connection between food pipe and wind pipe), he had to undergo tracheostomy (incision in wind pipe) and was put on Ryle’s tube feeding for over two years. Those procedures had been performed at a corporate hospital.
The patient was then referred to the surgical gastroenterology department at NIMS for further management.
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Though the team of doctors at NIMS have performed more than 400 Colonic Interpositions, this was a complex case given that radiotherapy had damaged the man’s oesophagus and trachea, the food and wind pipes were not connected properly, and certain part of oral cavity had been removed.
They aimed to disconnect an abnormal opening between his food pipe and wind pipe, and reconstruct the former with colonic interposition.
“The abnormal communication was identified and trachea (wind pipe) was repaired. As the oesophageal (food pipe) tissues were unhealthy with scarring, due to the previous radiotherapy, patient underwent colonic interposition, which is a major reconstructive procedure. It involves creation of a new conduit, using his large intestine, which is tunnelled all the way from his abdomen through the chest into the neck, reaching up to his mouth. It is a complex, skill-demanding surgery which with long conduit requires preserving good blood supply based on single artery and vein,” said N. Bheerappa, head of surgical gastroenterology.
The operation was performed free of cost under Aarogyasri Health Scheme. The patient is now able to take food orally. In due course of time, tracheostomy will be removed which will help him breathe normally and speak too. He was discharged on Sunday.