#AHT: The most unique surgery in the AHT Esophageal Pathology Center

Prof. Dr. Merab Kiladze, head of the Surgery Department at American Hospital Tbilisi performed a unique surgery. Three-quarters of the patient’s esophagus and stomach were cut off, an artificial esophagus was created from the stomach and  sutured to the  remaining part of the esophagus.

This major surgery is called  “subtotal esophagectomy and esophagogastroplasty”. According to Prof. Dr. Merab Kiladze, in the world medical literature only five surgeries of this severity and complexity have been described at iatrogenic injury of the esophagus and stent placement.

It all started a year ago, when a 58-year-old man from Batumi developed esophageal achalasia, or narrowing of the lower third of the esophagus, which made it difficult to swallow. He also underwent dilatation or widening of the esophagus in Turkey. During this procedure, the patient developed an iatrogenic injury and ruptured the esophagus. From the second day, he developed mediastinitis, i.e., inflammation of the posterior mediastinum, which was accompanied by high fever, swelling, pain, and shivering. 

The process ended with the insertion of a metal stent into the esophagus, which grew into the esophagus, causing erosions, ulceration, and inflammation. Unfortunately, the patient again faced the problem with which the treatment began – he found it difficult to swallow again. Although the Turkish doctors tried to remove the stent, but because it was embedded in the esophagus, they could not. 

After that, the 58-year-old man contacted Professor Dr.  Merab Kiladze, the head of the surgery department of American Hospital Tbilisi, who, after all the necessary investigations, successfully performed a unique and major operation. Currently, the patient feels well and has no difficulty in swallowing.