Esophagocolic Anastomotic Stricture Repaired Twelve Years after Original Interposition

Ludington, Louis G.; Lui, Alfred H.F.; Jones, John L.

doi:10.1378/chest.70.1.78

Cited by 3 publications

(1 citation statement)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although strictures can be dilated, dilation is difficult and revision is usually preferable. Corrective surgical procedures are often hampered by the limited length of the transplanted colon [9].…”

Section: Commentmentioning

confidence: 99%

Unusual Sequelae of Colon Interposition for Esophageal Reconstruction: Late Obstruction Requiring Reoperation

Sterling¹,

Kuykendall²,

Carmichael³

et al. 1984

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Colon interposition has become a favored technique for esophageal reconstruction. Late morbidity is generally related either to technical problems associated with the procedure or to the development of new disorders in the transposed segment. Two patients are discussed who were seen with obstruction of colon interposition grafts ten and five years after esophageal reconstruction. In the first patient, a volvulus of the interposed colon associated with a chronically narrowed area distal to the looped segment resulted in obstruction. In the second patient, the redundant intrathoracic segment of the colon interposition became kinked at the diaphragmatic hiatus leading to dilatation and incomplete emptying. Both patients underwent successful reoperations and are doing well 10 and 12 months later. The causes and possible prevention of these and other late complications of colon interposition are discussed.

show abstract

Section: Commentmentioning

confidence: 99%

Unusual Sequelae of Colon Interposition for Esophageal Reconstruction: Late Obstruction Requiring Reoperation

Sterling¹,

Kuykendall²,

Carmichael³

et al. 1984

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

show abstract

Angiodysplasia in Transposed Colon

Mittal

Khanuja²,

Amaria³

et al. 1988

Arch Surg

View full text Add to dashboard Cite

A challenging upper digestive tract continuity restoration after recurrent esophago-colonic anastomosis complications

Ferrante

Bassi

Diso

et al. 2022

J Cardiothorac Surg

View full text Add to dashboard Cite

Background Acute and chronic complications in esophago-colonic anastomosis have a significant impact in the postoperative course of patients with colonic transposition. Evidence about their management is poor and surgical treatment is mostly based on tailored approaches, so each new experience could be useful to improve knowledge about this peculiar condition. We report a unique case of an esophago-colonic resection and re-anastomosis without sternal approximation after recurrent anastomosis failure and strictures. Case presentation A 69-year-old woman was referred to our hospital for worsening dysphagia. The patient had undergone esophago-gastrectomy with right colon interposition 12 years prior due to caustic ingestion. The esophago-colonic anastomosis was initially complicated by an enterocutaneous fistula, which was treated with anastomosis resection and left colon transposition. This was then further complicated by dehiscence and sternal infection treated with resection of the distal portion of the sternum and a new colo-jejunal anastomosis. Finally, a chronic anastomotic stricture occurred, refractory to endoscopic dilatation and prothesis positioning. We planned a new colonic-esophageal resection and re-anastomosis. The main technical challenges were addressing the adhesions resulting from previous surgery and mobilizing an adequate length of the intestinal tract to allow conduit continuity restoration. Blood supply was assessed through Indocyanine Green Fluorescence. To avoid compression of the digestive conduit sternal margins were not re-approximated, and the transposed tube was covered and protected using both pectoralis major muscles flap. We decided to avoid the use of any prosthetic material to reduce the risk of infection. The patient was able to resume oral food intake on the 12th day postoperatively after a barium swallowing test showed an adequate conduit caliber. Conclusion Esophago-colonic anastomosis complications represent a life-threatening condition. Therefore, reports and sharing of knowledge are important to improve expertise in management of these conditions.

show abstract

Esophagocolic Anastomotic Stricture Repaired Twelve Years after Original Interposition

Cited by 3 publications

References 3 publications

Unusual Sequelae of Colon Interposition for Esophageal Reconstruction: Late Obstruction Requiring Reoperation

Unusual Sequelae of Colon Interposition for Esophageal Reconstruction: Late Obstruction Requiring Reoperation

Angiodysplasia in Transposed Colon

A challenging upper digestive tract continuity restoration after recurrent esophago-colonic anastomosis complications

Contact Info

Product

Resources

About