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Esophageal replacement by colon interposition

R J Cerfolio1, M S Allen, C Deschamps

  • 1Section of General Thoracic Surgery, Mayo Clinic, Rochester, MN 55905, USA.

The Annals of Thoracic Surgery
|June 1, 1995
PubMed
Summary
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Colon interposition for esophageal replacement showed acceptable long-term eating function in 29 survivors. However, this procedure had considerable early morbidity and mortality, with a 9% operative death rate.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Esophageal replacement is a complex procedure.
  • Colon interposition is an alternative conduit for esophageal replacement.
  • Indications for colon interposition include gastric inadequacy and esophageal cancer.

Purpose of the Study:

  • To evaluate the long-term outcomes of colon interposition for esophageal replacement.
  • To assess the morbidity and mortality associated with this procedure.

Main Methods:

  • Retrospective review of 32 patients undergoing colon interposition for esophageal replacement between 1985 and 1993.
  • Analysis of operative details, complications, mortality, and long-term functional outcomes.
  • Follow-up ranged from 15 months to 7 years.

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Main Results:

  • Operative mortality was 9%, with causes including ischemic necrosis and adult respiratory distress syndrome.
  • Major complications occurred in 4 patients, including ischemic colitis and anastomotic leak.
  • At long-term follow-up, 26 of 29 survivors had good eating function, though 7 required anastomosis dilation.

Conclusions:

  • Colon interposition offers acceptable long-term esophageal replacement function.
  • The procedure is associated with significant early morbidity and mortality.
  • Careful patient selection and surgical technique are crucial for optimizing outcomes.