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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
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Colonic interposition, a contemporary experience: technical aspects and outcomes.

Naomi M Fearon1, Helen M Mohan2, Michelle Fanning2

  • 1The National Oesophageal and Gastric Cancer Centre, St James Hospital, Dublin 8, Ireland. naomifearon@rcsi.ie.

Updates in Surgery
|November 12, 2020
PubMed
Summary

Colonic interposition is a rare but viable esophageal replacement technique. Despite its infrequent use, this method can achieve good long-term functional and nutritional outcomes, even in complex cases.

Keywords:
Colon interpositionOesophageal cancerSurgical techniquesUpper gastrointestinal surgery

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Area of Science:

  • Surgery
  • Gastroenterology
  • Oncology

Background:

  • Colonic interposition is infrequently used for esophageal replacement compared to gastric conduits due to perceived higher risks and unpredictable outcomes.
  • High-volume esophageal centers may still encounter specific indications for this reconstructive technique.

Purpose of the Study:

  • To document the experience, indications, techniques, and functional outcomes of colonic interposition for esophageal replacement at a high-volume center.
  • To evaluate the long-term results and quality of life in patients undergoing colonic interposition.

Main Methods:

  • Retrospective review of a prospective database from 2012 to 2016.
  • Analysis of four cases (1.5% of 252 esophageal resections) that utilized colonic interposition.
  • Inclusion of diverse indications: gastric conduit necrosis, caustic ingestion with fistula, and primary malignancy post-gastrectomy.

Main Results:

  • Two of three cancer patients survived disease-free at 3 and 5 years.
  • Surviving patients achieved weight stability and tolerated a normal diet.
  • Excellent quality of life was reported by surviving patients, assessed using validated tools.

Conclusions:

  • Colonic interposition, though rare, can yield good long-term nutritional and functional results in esophageal reconstruction.
  • This technique remains a valuable option in specialist centers, necessitating specific training approaches due to its rarity.