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Ann Thorac Surg. 1997 Sep;64(3):757-64.

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

Author information

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

Abstract

BACKGROUND:

In contrast to the use of the stomach as an esophageal substitute, the use of the colon is becoming uncommon.

METHODS:

From 1985 to 1995, 60 patients underwent colon interposition for esophageal cancer (n = 37), benign stricture (n = 13), iatrogenic fistula (n = 5), achalasia (n = 3), or necrosis of a previous substitute (n = 2). A long isoperistaltic conduit based on the left colonic artery could be used in 52 patients (86.7%). The surgical route used was through the esophageal bed in 38 patients (63.3%), under the sternum in 21 patients, and under the skin in 1 patient.

RESULTS:

Colon interposition represented 18.5% of all operations performed for esophageal substitution during the study period. The choice of the colon resulted from an inadequate stomach in 33 cases (55%). The operative mortality rate was 8.3%. Seven patients (13.5%) required dilation of the esophagocolonic anastomosis. At last follow-up, 34 patients (65.4%) had no difficulty eating. Multivariate analysis identified the conduit position in the posterior mediastinum as the sole independent predictor of a good functional result (p = 0.002).

CONCLUSIONS:

Colon interposition for esophageal substitution, usually performed when the stomach is not available, provides satisfactory function when placed in the esophageal bed.

PMID:
9307470
[Indexed for MEDLINE]

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