Q) In patients undergoing delayed reconstruction following caustic esophageal injury, which of the following statements best reflects findings from clinical outcomes comparing gastric and colonic conduits?
A. Transhiatal esophagectomy with cervical esophagogastrostomy shows poor long-term survival due to conduit necrosis B. Anastomotic strictures are rare following cervical esophagogastrostomy and seldom require intervention C. Colon grafts are preferred over gastric conduits due to lower rates of reflux and aspiration D. Gastric conduits are functionally superior to colonic grafts and associated with fewer postoperative complications
Ans c
Colon grafts are preferred by some authors over gastric conduits due to lower rates of reflux and aspiration
A is incorrect: The review showed good overall survival, not poor outcomes.
B is incorrect: Almost half developed strictures requiring an average of three dilations, so strictures are common.
C is correct: Authors recommend colon grafts due to reduced reflux and aspiration risk compared to gastric conduits.
D is incorrect: While gastric conduits are commonly used, colon is considered functionally superior in certain cases due to its straighter course and less reflux.
Q) Which of the following is not a component of the Pittsburgh Severity Score used to assess esophageal perforation severity?
A. Age over 75 years B. Time to diagnosis over 24 hours C. Presence of pleural effusion D. Length of the esophageal perforation
Ans d
D. Length of the esophageal perforation
Explanation:
A. Age over 75 years Included: Advanced age is a poor prognostic factor and is part of the scoring system.
B. Time to diagnosis over 24 hours Included: Delay in diagnosis significantly increases mortality and is an important parameter in the score.
C. Presence of pleural effusion Included: Indicates more extensive mediastinal or pleural contamination; included in the score.
D. Length of the esophageal perforation Not included: The Pittsburgh Severity Score does not consider the physical length of the perforation. It focuses more on clinical and radiological parameters.
