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Related Experiment Videos

Esophageal replacement with colon interposition in children.

M M Stone, E W Fonkalsrud, G H Mahour

    Annals of Surgery
    |April 1, 1986
    PubMed
    Summary

    Colon interposition surgery offers excellent outcomes for children with esophageal atresia and benign strictures, with 84% achieving excellent results. This procedure is a safer alternative to esophageal elongation for complex cases.

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    Area of Science:

    • Pediatric Surgery
    • Thoracic Surgery
    • Gastroenterology

    Background:

    • Colon interposition is a reconstructive surgical technique used for esophageal replacement.
    • Indications include esophageal atresia and benign esophageal strictures in pediatric patients.
    • Long-term outcomes and complication rates require thorough evaluation.

    Purpose of the Study:

    • To evaluate the long-term outcomes and complications of colon interposition in pediatric patients.
    • To compare the outcomes of retrosternal versus left thoracic colon interposition.
    • To assess the efficacy of colon interposition as an alternative to esophageal elongation for esophageal atresia.

    Main Methods:

    • Retrospective review of 39 colon interposition operations in 37 children over 21 years.

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  • Analysis of patient demographics, indications, surgical approach (retrosternal vs. left thoracic), and colon segment orientation (isoperistaltic vs. reverse).
  • Assessment of postoperative complications, functional outcomes (weight gain, transit/emptying), and long-term results.

    • Main Results:

    • Overall, 84% of patients had excellent results with a mean follow-up of 9.7 years.
    • Common complications included anastomotic leak (12) and stricture (14).
    • Isoperistaltic colon segments demonstrated better transit and emptying; retrosternal segments had less distension than left thoracic.
    • 32 of 36 children increased their weight percentile post-operation.

    Conclusions:

    • Colon interposition is a safe and effective procedure for pediatric esophageal reconstruction, yielding excellent long-term results.
    • Retrosternal isoperistaltic colon interposition appears to offer better functional outcomes.
    • This technique is a viable and potentially safer alternative to prolonged esophageal elongation in complex esophageal atresia cases.