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Long-segment colon interposition for acquired esophageal disease.
J C Wain1, C D Wright, E Y Kuo
1Division of Thoracic Surgery, Massachusetts General Hospital, Boston 02114, USA. wain.john@mgh.harvard.edu
The Annals of Thoracic Surgery
|April 10, 1999
Summary
Long colon interposition is a safe and effective esophageal replacement for acquired esophageal diseases, offering good long-term functional results for patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Thoracic Surgery
Background:
- Long-segment colon interposition is a surgical technique for esophageal replacement.
- Its indications, morbidity, and functional outcomes for acquired esophageal disease remain debated.
Purpose of the Study:
- To evaluate the safety and functional results of long colon interposition for acquired esophageal disease.
Main Methods:
- Retrospective review of 52 patients undergoing long colon interposition from 1956 to 1997.
- Analysis of medical records, office visits, and operative reports.
- Categorization of indications including caustic injury, gastroesophageal disease, irradiation, motility disorders, and esophageal absence.
Main Results:
- The left colon was used in 46 patients; the right colon in 6.
- In-hospital mortality was 4%. Early complications included graft ischemia and anastomotic leak.
- Late complications included anastomotic stenosis (26 patients) and bile reflux (1 patient). Swallowing function was good to excellent in 90% of patients.
Conclusions:
- Long colon interposition can be safely performed for acquired esophageal disease.
- The procedure offers acceptable long-term functional results.