HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kamal A. Mansour F. Curtis Bryan Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mansour, K. A. Articles by Carlson, G. W. Search for Related Content PubMed PubMed Citation Articles by Mansour, K. A. Articles by Carlson, G. W.

Ann Thorac Surg 1997;64:752-756
© 1997 The Society of Thoracic Surgeons

---

Original Article: General Thoracic

Bowel Interposition for Esophageal Replacement: Twenty-Five–Year Experience

Joseph B. Whitehead Department of Surgery, Divisions of Cardiothoracic and Plastic and Reconstructive Surgery, Emory University School of Medicine, Atlanta, Georgia

Background. From 1972 to 1996, bowel interposition reconstruction after esophagectomy for benign and malignant conditions was performed in 129 of 131 patients. The indication for operation was benign disease in 94 patients (72.9%) and malignant disease in 35 patients (27.1%). Benign stricture was the most common presentation in the benign group (41 patients), and adenocarcinoma was the most common indication in the malignant group (19 patients).

Methods. One hundred thirty-three conduits were performed in the 129 patients. Four patients (3.1%) required reoperative reconstruction. Of the 97 conduits employed for reconstruction of benign disease, the right colon was used in 70 patients, the left colon in 9 patients, and the transverse colon in 4 patients. A jejunal interposition graft was employed in 11 patients and a free jejunal autograft in 3 patients. The right colon was used in 15 patients with malignant disease, the left colon in 9 patients, and the jejunum in 12 patients.

Results. The mean age of the population was 54.5 years (range, 14 to 72 years) with a male-to-female ratio of 1.3:1. The average number of prior thoracic or abdominal procedures was 2.9 (range, 1 to 8) with 50.9% of patients undergoing reoperation. The mean length of stay was 21.7 days (range, 8 to 290 days). Complications occurred in 37.1% of patients with anastomotic leak occurring in 14.8% and ischemic colitis in 3.0% of conduits performed. The in-hospital mortality was 5.9%.

Conclusions. Bowel interposition reconstruction after esophagectomy for benign and malignant disease can be performed with an acceptable morbidity and mortality, despite prior operative procedures in the abdomen or chest. Colonic and jejunal conduits, employed alone or in combination, can effectively restore gastrointestinal continuity.

This article has been cited by other articles:

				D. X. Li, M. S. Levine, S. E. Rubesin, and I. Laufer Nonanastomotic Strictures After Colonic Interposition Am. J. Roentgenol., July 1, 2007; 189(1): 30 - 34. [Abstract] [Full Text] [PDF]

				S. Motoyama, M. Kitamura, R. Saito, K. Maruyama, Y. Sato, K. Hayashi, H. Saito, Y. Minamiya, and J.-i. Ogawa Surgical Outcome of Colon Interposition by the Posterior Mediastinal Route for Thoracic Esophageal Cancer Ann. Thorac. Surg., April 1, 2007; 83(4): 1273 - 1278. [Abstract] [Full Text] [PDF]

				B. Tuncozgur, M. C. Savas, A. F. Isik, A. Sarimehmetoglu, M. Sanli, and L. Elbeyli Removal of Metallic Stent by Using Polyflex Stent in Esophago-Colic Anastomotic Stricture Ann. Thorac. Surg., November 1, 2006; 82(5): 1913 - 1914. [Abstract] [Full Text] [PDF]

				M. S. Kent, L. Gayle, L. Hoffman, and N. K. Altorki A New Technique of Subcutaneous Colon Interposition Ann. Thorac. Surg., December 1, 2005; 80(6): 2384 - 2386. [Abstract] [Full Text] [PDF]

				A. Altorjay, J. Kiss, B. Paal, Z. Tihanyi, F. Luka, Z. Farsang, I. Asztalos, and I. Altorjay The place of gastro-jejuno-duodenal interposition following limited esophageal resection Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 296 - 300. [Abstract] [Full Text] [PDF]

				P. A. Davis, S. Law, and J. Wong Colonic Interposition After Esophagectomy for Cancer Arch Surg, March 1, 2003; 138(3): 303 - 308. [Abstract] [Full Text] [PDF]

				D. P. MacMillan, I. G. Duarte, K. A. Mansour, and S. Sundaresan McKeown esophagogastrectomy for esophageal carcinoma after free jejunal graft Ann. Thorac. Surg., May 1, 2002; 73(5): 1649 - 1651. [Abstract] [Full Text] [PDF]

				H.-C. Chen, B.-K. Tan, M.-H. Cheng, C.-H. Chang, and Y.-b. Tang Behavior of free jejunal flaps after early disruption of blood supply Ann. Thorac. Surg., March 1, 2002; 73(3): 987 - 989. [Abstract] [Full Text] [PDF]