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Thorac Cardiovasc Surg. 2018 Aug;66(5):384-389. doi: 10.1055/s-0037-1606828. Epub 2017 Oct 9.

Surgical Outcome of Colon Interposition in Esophageal Cancer Surgery: Analysis of Risk Factors for Conduit-Related Morbidity.

Author information

1
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, the Republic of Korea.
2
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, the Republic of Korea.

Abstract

BACKGROUND:

We aimed to assess the feasibility, surgical outcomes, and conduit-related complications of colon interposition in patients with esophageal cancer.

METHODS:

Patients with esophageal cancer who underwent colon interposition for esophageal reconstruction between June 2000 and June 2013 were retrospectively reviewed.

RESULTS:

A total of 67 consecutive patients (mean age, 62.2 ± 7.9 years) were enrolled. During this time period, 944 patients underwent esophageal reconstruction using gastric conduit. Twelve patients (17.9%) also received neoadjuvant chemoradiotherapy (nCRT). The median follow-up duration was 44 months (range, 1-168 months); median survival duration was 63 months (range, 1-168 months); and 3- and 5-year overall survival rates were 61.6 and 49.4%, respectively. A total of 43 patients (64.2%) experienced at least 1 postoperative morbidity. According to the Clavien-Dindo grading system, 36 patients (54%) experienced postoperative morbidity of higher than Grade III. Pulmonary complications were most commonly observed complications among the patients (18 patients, 26.9%). Anastomosis site leakage developed in 11 patients (16.4%), and 3 of these patients (6.0%) eventually experienced graft failure. On multivariate analysis, nCRT was determined as a significant risk factor for conduit-related complications (leakage, graft failure, fistula, and stricture).

CONCLUSION:

Colon interposition is associated with relatively high complication rates, whereas nCRT is associated with conduit morbidity.

PMID:
28992653
DOI:
10.1055/s-0037-1606828
[Indexed for MEDLINE]

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