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Updated: Oct 5, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Operative outcomes and long-term survival of patients undergoing colon interposition after esophagectomy for cancer
Tomohiro Akutsu1, Takeo Fujita1, Daisuke Kajiyama1
1Division of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan.
Background:
The first choice of an esophageal substitute after esophagectomy for cancer is the stomach. However, the colon must be considered for reconstruction in specific situations. The purpose of this study was to clarify the frequency and clinical features of patients who underwent colon interposition in thoracic esophagectomy and to investigate the postoperative complications and survival.
Methods:
We conducted a retrospective case-control study in the National Cancer Center Hospital East, Japan. Patients who underwent colon interposition after esophagectomy for cancer between 2010 and 2020 were analyzed.
Results:
Eighty-eight patients underwent esophagectomy with colon interposition; 53.2% received preoperative treatment and 52.3% underwent thoracoscopic surgery. Clavien-Dindo grade >III postoperative complications occurred in 42% of the patients; anastomotic leakage was the most common complication, occurring in 26.1% of the cases. Univariate analysis of the factors associated with Clavien-Dindo grade
Conclusion:
In colon reconstruction after esophageal cancer resection, totally mechanical Collard anastomosis for cervical anastomosis may reduce the risk of Clavien-Dindo grade >III complications.
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