Colon interposition after esophagectomy: a 15-year single-center experience

Area of Science:

• Gastroenterology
• Surgical Oncology
• Thoracic Surgery

Background:

• Colonic interposition is a preferred method for esophageal reconstruction when gastric pull-up is not feasible.
• This study evaluates perioperative outcomes of colonic interposition over 15 years.

Purpose of the Study:

• To assess the outcomes of colonic interposition for esophageal replacement in a tertiary-care setting.
• To identify complications and mortality associated with this procedure.

Main Methods:

• A retrospective review of a prospectively maintained database of patients undergoing colonic interposition.
• Descriptive statistical analysis of perioperative outcomes.

Main Results:

• 93 patients underwent colonic interposition, primarily for malignancy (82.8%).
• Major complications included anastomotic leakage (28%) and stenosis (30.1%).
• High rates of reoperation (38.7%), prolonged hospital stay (29 days), and in-hospital mortality (18.3%) were observed.

Conclusions:

• Colonic interposition is associated with significant morbidity and mortality.
• The procedure should be reserved for experienced, high-volume centers, especially in salvage and secondary reconstruction settings.