Surgical management of failed colon interposition.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Digestive Surgery

Background:

• Colon interposition complications can be acute or chronic and devastating.
• Creative strategies are needed to preserve or replace the conduit.
• Management of post-operative complications presents significant challenges.

Purpose of the Study:

• To review revision surgeries for colon interposition.
• To identify common complications and their management.
• To present successful strategies for managing devastating complications.

Main Methods:

• Retrospective review of patient records.
• Analysis of 35 patients undergoing 48 operative revisions between 1965 and 2005.
• Categorization of indications and revisional operations.

Main Results:

• Most common indications: redundancy (13), stricture (11), loss of intestinal continuity (8).
• Most common operations: anastomotic revision (13), segmental colonic resection (6), stricturoplasty (4).
• Swallowing restored in 32/35 patients; loss of continuity reversed in 6/7 patients. No intraoperative deaths.

Conclusions:

• Complications after colon bypass pose major challenges to swallowing and quality of life.
• Successful strategies exist for managing these severe complications.
• This is the largest report on diverse colon bypass complications.