Reconstruction of the Esophagus With Left Colon

Belsey, Ronald

doi:10.1016/s0022-5223(19)33318-5

Cited by 211 publications

(30 citation statements)

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“…During the last decades the colon has be used as the most common substitute for total or subtotal esophageal reconstructions. [1][2][3][4][5][6][7][8] The technique of the operation during the time has improved, but generally it has not changed. The colon has a number of attributes that make it an excellent option in esophageal replacement.…”

Section: Discussionmentioning

confidence: 99%

Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience

Knežević¹,

Radovanović²,

Simić³

et al. 2007

Diseases of the Esophagus

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The objective of this article was to analyze 40 years of experience of colon interposition in the surgical treatment of caustic esophageal strictures from the standpoints of our long-term personal experience. Colon interposition has proved to be the most suitable type of reconstruction for esophageal corrosive strictures. The choice of colon graft is based on the pattern of blood supply, while the type of anastomosis is determined by the stricture level and the part of colon used for reconstruction. In the period between 1964 and 2004, colon interposition was performed in 336 patients with a corrosively scared esophagus, using the left colon in 76.78% of the patients. In 87.5% a colon interposition was performed, while in the remaining patients an additional esophagectomy with colon interposition had to be done. Hypopharyngeal strictures were present in 24.10% of the patients. Long-term follow-up results were obtained in the period between 1 to up to 30 years. Early postoperative complications occurred in 26.48% of patients, among which anastomosic leakage was the most common. The operative mortality rate was 4.16% and late postoperative complications were present in 13.99% of the patients. A long-term follow up obtained in 84.82% of the patients found excellent functional results in 75.89% of them. We conclude that a colon graft is an excellent esophageal substitute for patients with esophageal corrosive strictures, and when used by experienced surgical teams it provides a low rate of postoperative morbidity and mortality, and long-term good and functional quality of life.

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Section: Discussionmentioning

confidence: 99%

Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience

Knežević¹,

Radovanović²,

Simić³

et al. 2007

Diseases of the Esophagus

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“…Injury to the recurrent laryngeal nerve was not encountered in our patients because we deliberately identify it before any mobilisation of the cervical oesophagus is performed. Redundancy of the interposed colonic substitute may lead to dysphagia or lung compression (5). This can be avoided by stretching the graft from the neck incision and removing any excess before the oesophagocolic anastomosis is performed and suture of the graft to the margins of the oesophageal hiatus.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Functional Results of Transhiatal Oesophagectomy and Colonic Interposition for Caustic Oesophageal Stricture

Bassiouny

Al-Ramadan²,

Al-Nady³

2002

Eur J Pediatr Surg

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Aim of the study. Various surgical procedures have been advocated for replacement of the scarred oesophagus in children. We report here on our experience of oesophago-coloplasty. Methods. Over a 10-year period, 100 children (62 boys, 38 girls) with intractable caustic stricture of the oesophagus underwent transhiatal oesophagectomy and left colonic interposition. Their age at the time of reconstruction ranged from 14 months to 8 years (mean 3.4 years). Results. The patients were followed up post reconstruction for a period ranging from 5 to 15 years. There were 3 deaths from respiratory failure. Stricture of the cervical oesophagocolic anastomosis occurred in 6 patients and needed repeated dilatations (in 2 patients) and surgical revision (in 4 patients). Mild redundancy of the colonic substitute in the chest was noted in five cases, but in no case there was dysphagia necessitating revision of the colonic transplant. Peptic ulcer or symptomatic gastric-colic reflux was not seen in this group of patients. All of our patients are able to swallow and eat a normal unrestricted diet, they are gaining weight and enjoying a normal life pattern. Conclusion. We conclude that isoperistaltic left colon, based on both the ascending and descending branches of the left colic vessels with simultaneous oesophagectomy utilising the transhiatal approach, is the best substitute for a scarred oesophagus in children with satisfactory long-term functional results.

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“…9 However, comparison of our results to those of other studies that used the midcolon as an esophageal substitute is limited because of differences in patients, in type of surgery or in time period in which the data were generated. [15][16][17][18][19][20]…”

Section: Discussionmentioning

confidence: 99%

Colon interposition in the treatment of corrosive esophageal strictures: 100 patients in seven years

Sharma

Pancholi

2019

Int Surg J

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This is a study of 100 cases of corrosive stricture of esophagus managed with colon interposition within duration of seven years. With improved knowledge after review of literature and experience of more frequent procedures, we changed our technique of surgery with decreased operative time and better understanding of ABSTRACT Background: The purpose of this study is to represent the change in our concept of principles and techniques of esophagocoloplasty (midcolon esophagocoloplasty) with repetitive performance of the operation and approach of early surgical intervention (within 4-6 month of corrosive ingestion) in place of repetitive trials of dilatations and medical management, provides early better quality of life with lesser period of suffering and saving expenditure of treatment. Methods: This retrospective study comprises of consecutive 100 patients operated for colon interposition for corrosive stricture of esophagus done at two university linked government teaching hospitals during March 2011 to March 2018. Out of 100 patients, 77 female and 23 male (3:1), mean age 30.6 years (range from 21 to 47 years), mean hospital stay was 14.5 days (range 10 to 25 days) and mean operative duration was 4.5 hours (range 2.5 to 7 hours). Results: The 30 day in hospital mortality rate was 9%. There were 14 instances of leak at the esophagocolic anastomosis (14%), graft necrosis occurred in 01 patient, 08 patients (8%) developed stenosis at the esophagocolic anastomosis. More than 90% patients (n=77) had 'Good' result, 06 patients had 'Fair' and 02 had 'Poor' result. Conclusions: Midcolon graft is a solution for confusion in judgment of adequate length of graft and offer uniformity in procedure with effectively lesser operative time. Early (4-6 months after ingestion) operative intervention is advantageous to patients suffering from crippling dysphagia with repeated admission and expenditure from multiple endoscopic dilatations.

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Reconstruction of the Esophagus With Left Colon

Cited by 211 publications

References 0 publications

Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience

Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience

Long-Term Functional Results of Transhiatal Oesophagectomy and Colonic Interposition for Caustic Oesophageal Stricture

Colon interposition in the treatment of corrosive esophageal strictures: 100 patients in seven years

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