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Colon interposition in children.

I M Mitchell1, D W Goh, K D Roberts

  • 1Department of Cardiothoracic Surgery, Birmingham Children's Hospital, UK.

The British Journal of Surgery
|July 1, 1989
PubMed
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Colonic interposition surgery in children, particularly for long-gap esophageal atresia, shows a 94% satisfactory swallowing outcome. However, complications like leakage and stricture formation necessitate careful surgical route selection, favoring transthoracic over retrosternal approaches.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Colonic interposition is a reconstructive surgery for esophageal defects in children.
  • Long-gap esophageal atresia and post-esophagectomy strictures are common indications.

Purpose of the Study:

  • To review the outcomes and complications of 80 colonic interpositions in 79 children performed since 1960.
  • To compare the efficacy and safety of different surgical routes.

Main Methods:

  • Retrospective review of pediatric patients undergoing colonic interposition.
  • Analysis of surgical approach (transthoracic vs. retrosternal), complications, and long-term outcomes.

Main Results:

  • Overall mortality was 12%. Graft failure occurred in 10% of cases.

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  • Complications included proximal anastomosis leakage (31%), stricture formation (27%), and acid reflux (30%).
  • The transthoracic route was favored over the retrosternal route due to a lower incidence of serious complications.

    • Conclusions:

    • Colonic interposition offers satisfactory swallowing function in 94% of pediatric patients.
    • Surgical approach significantly impacts complication rates, with the transthoracic route being preferable.
    • Long-term follow-up is crucial for managing complications such as strictures and reflux.