Esophageal Reconstruction by Colon Interposition

El-Domeiri, Ali A.; Martini, Nael; Beattie, Edward J.

doi:10.1001/archsurg.1970.01340220034006

Cited by 31 publications

(4 citation statements)

References 6 publications

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“…Various authors report operative mortalities of 10-28 per cent for oesophageal intubation by the pullthrough technique and the 18 per cent operative mortality of this series is within that range. These figures compare favourably with those for various bypass procedures and palliative resections, in which the operative mortality is generally higher (10-60 per cent) and the palliation achieved often unsatisfactory (Allison and Borrie, 1949;Barnard et al, 1966;El Domeiri et al, 1970;Postlethwaite et al, 1971;Stephens, 1971).…”

Section: Discussionmentioning

confidence: 73%

“…Palliative procedures to relieve dysphagia are, therefore, of considerable importance and ideally these procedures should be both safe and simple. Bypass procedures have been tried by a number of authors (Allison and Borrie, 1949;Miller, 1962;Barnard et al, 1966;El Domeiri et al, 1970;Postlethwaite et al, 1971 ;Stephens, 1971), but the mortality from these operations may reach 60 per cent and the palliation is often unsatisfactory. Better results have been achieved by intubation of the malignant stricture, as first suggested by Leroy d'Etiolles of France in 1845 (Celestin, 1959).…”

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confidence: 99%

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The Celestin tube in the palliation of carcinoma of the oesophagus and cardia

Saunders

1979

British Journal of Surgery

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A series of 105 patients with dysphagia due to inoperable carcinoma of the oesophagus or cardia of the stomach, and 11 patients with dysphagia secondary to malignant medistinal nodes, was treated by intubation with a Celestin tube. The hospital mortality was high but 81 patients left hospital and 29 were still alive at 6 months. The prognosis for those with dysphagia due to malignant posterior mediastinal nodes was very poor, with no survivors at 6 months. Oesophageal perforation was a serious operative complication, with a hospital mortality of 83 per cent. Chest and wound infections were the most common postoperative complications occurring in 28 and 20 per cent of the patients, respectively. The restoration of swallowing was satisfactory in the majority of survivors although readmission with a blocked or displaced tube was not uncommon.

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Section: Discussionmentioning

confidence: 73%

mentioning

confidence: 99%

The Celestin tube in the palliation of carcinoma of the oesophagus and cardia

Saunders

1979

British Journal of Surgery

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“…The following complications can be emphasized in order of frequency. The anastomotic leak is a serious early complication accounting for 32-50% of all complications [3][4][5][6]. Of these, 53% persisted as fistulous tracts [7].…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma from Esophageal Clonic Interposition

Lin¹,

Lin²

2008

Chir Gastroenterol

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Background: Colon interposition has become the gold standard for treating patients with congenital or acquired, benign or malignant esophageal strictures. However, a variety of late complications have been reported, including anastomotic leak, anastomotic stricture, gastro-colic reflux, and colon-graft stricture. Case Report: We here reported the case of 74-year-old female who was admitted to our hospital due to the serious dysphagia for 2 months and apparent loss of weight. The patient had undergone esophageal reconstruction using colonic interposition for esophageal malignancy at the age of 41. As proven by histopathology, the patient presented with the rare complication of an adenocarcinoma developing in the graft. Conclusions: The new onset of dysphagia after surgery is likely to be due to the recurrent malignancy. We review the actual literature concerning complications of colon interposition and discuss the postoperative morbidity as a cause of recurrent dysphagia or other symptoms.

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“…Slightly better survival rates can be found in series where surgery alone was used, but in many investigations almost 50% of the patients have been adjudged inoperable and even fewer were suitable for resection at operation.6'12 Patients who have received operations with curative intention have had a high postoperative mortality ranging from 15% to 40%.12 Surgery in the form of a colon bypass has been reported to relieve dysphagia in 51% of the patients, who were then able to eat normally for the rest of their lives, while only temporary relief was attained in 17% of the patients, and they were then restricted to the intake of liquids and soft food. 2 The problem with the surgical approach to esophageal cancer is twofold.…”

Section: Discussionmentioning

confidence: 99%

Surgery alone or combined with radiation therapy in esophageal carcinoma

Hambraeus

Mercke

Hammar

et al. 1981

Cancer

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Two patient-materials with esophageal carcinoma are analyzed: a group of 22 patients who, during the period 1971-1974, were treated with esophageal resection followed by esophagogastrostomy or colonic interpolation; a second group of 28 patients from 1975-1978, who were treated in the same way, but also given either preoperative or postoperative radiation therapy, or both. Surgical mortality was about the same in the two groups: 25-32%. The group given radiation therapy had a one-year survival rate of 50%, as compared with 23% in the group treated solely with surgery. All 24 patients given combined therapy, with all or part of the absorbed dose of 24-47 Gy given preoperatively, showed vital cancer in resected specimens. Vital cancer was found in the periesophageal nodes in only six patients (25%), however; patients given no preoperative radiation therapy had tumor in 20 of 26 cases (77%; P less than 0.01). Celiac nodes were resected at laparotomy; when malignancy was found, the celiac region was irradiated postoperatively. This finding does not appear to exclude long-term survival, as two patients with metastases to the celiac nodes at operation are alive 16 and 20.5 months following surgery. Simple compared to troublesome dissection gives a better rate of survival. The spleen was unintentionally injured in 21 patients at laparotomy and had to be removed. One-year survival was better in patients with intact spleen, especially in those who also had radiation therapy. Patients with resected spleen succumbed from metastases more often than from mediastinal recurrence, as compared with the patients with intact spleen.

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Esophageal Reconstruction by Colon Interposition

Cited by 31 publications

References 6 publications

The Celestin tube in the palliation of carcinoma of the oesophagus and cardia

The Celestin tube in the palliation of carcinoma of the oesophagus and cardia

Adenocarcinoma from Esophageal Clonic Interposition

Surgery alone or combined with radiation therapy in esophageal carcinoma

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