Arguments against long-term conservative treatment of oesophageal strictures due to corrosive burns.

Thirty-two patients are presented with late complications after a corrosive burn of the oesophagus. From this group of 32 cases 11 had fistulae and mediastinal abscesses after perforation of the gullet; 11 patients developed a tight peptic stricture in the narrowed oesophagus due to traction-type hiatal hernia as a result of the longitudinal contraction of the fibrotic oesophagus; cancer developed in the corrosive stricture in 10 patients, inoperable in five. Arguments against long-term conservative treatment of narrowed and fibrotic oesophageal strictures are presented. Early operation gives final relief from dysphagia and prevents late complications. The risk of intrathoracic oesophageal replacement with a segment of bowel/colon or jejunum in uncomplicated cases is 2·4% in our series of 42 cases.