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Colon interposition for esophageal replacement: current indications and long-term function

P Thomas1, P Fuentes, R Giudicelli

  • 1Department of Thoracic Surgery, University of Marseille, France.

The Annals of Thoracic Surgery
|October 6, 1997
PubMed
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Colon interposition is a viable esophageal substitute, especially when the stomach is unavailable. Placing the colon conduit in the esophageal bed predicts good functional outcomes for patients undergoing esophageal substitution surgery.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Thoracic Surgery

Background:

  • Esophageal substitution is crucial for various conditions.
  • Stomach is a common substitute, but colon interposition is less frequent.
  • This study evaluates colon interposition's efficacy and outcomes.

Purpose of the Study:

  • To assess the outcomes of colon interposition for esophageal substitution.
  • To identify factors influencing functional results.
  • To determine the role of colon interposition when stomach is unavailable.

Main Methods:

  • Retrospective analysis of 60 patients undergoing colon interposition (1985-1995).
  • Indications included esophageal cancer, benign stricture, fistula, achalasia, and previous substitute necrosis.

Related Experiment Videos

  • Surgical routes varied: esophageal bed, substernal, or subcutaneous.

    • Main Results:

    • Colon interposition accounted for 18.5% of esophageal substitutions, often due to stomach unavailability (55%).
    • Operative mortality was 8.3%; 13.5% required anastomosis dilation.
    • Good eating function was achieved in 65.4% of patients.

    Conclusions:

    • Colon interposition offers satisfactory function for esophageal substitution, particularly when the stomach is not an option.
    • Conduit placement within the esophageal bed is a key predictor of successful functional outcomes.
    • This technique remains a valuable reconstructive option in specific clinical scenarios.