Colonic interposition and supercharge for esophageal reconstruction

• Published in: Langenbeck's archives of surgery Vol. 391; no. 1; pp. 19 - 23
• Main Authors: Shirakawa, Yasuhiro, Naomoto, Yoshio, Noma, Kazuhiro, Sakurama, Kazufumi, Nishikawa, Toshio, Nobuhisa, Tetsuji, Kobayashi, Masahiko, Okawa, Takaomi, Asami, Shinya, Yamatsuji, Tomoki, Haisa, Minoru, Matsuoka, Junji, Hanazaki, Motohiko, Morita, Kiyoshi, Hiraki, Takao, Tanaka, Noriaki
• Format: Journal Article
• Language: English
• Published: Germany 01.02.2006
• Subjects: Adult; Aged; Aged, 80 and over; Anastomosis, Surgical - methods; Colon - surgery; Esophageal Neoplasms - surgery; Esophagus - surgery; Female; Gastrectomy; Humans; Male; Middle Aged; Neoplasm Staging; Postoperative Complications; Quality of Life; Reconstructive Surgical Procedures - methods; Stomach Neoplasms - surgery; Treatment Outcome; Vagus Nerve - surgery
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-005-0010-8

We evaluated the techniques of colonic interposition and supercharge for esophageal reconstruction and discussed the main considerations related to these procedures. In this study, we performed 51 esophageal reconstructions using colonic interposition. Twenty-eight of the 51 patients had synchronous or allochronic gastric malignancy. We selected colonic interposition for high anastomosis in 11 patients and also for esophageal bypass in 3 patients. This procedure was also selected to preserve gastric function in 5 patients. We recently performed the supercharge technique for colonic interposition in 41 patients. Despite the long duration and multistep nature of the operation procedure, no perioperative complications were noted. The patients returned to a good quality of life. The incidence of postoperative weight loss did not differ significantly between the colonic reconstruction group and the gastric reconstruction group. In terms of heartburn and dumping syndrome, the outcome was markedly better in the colonic reconstruction group (no cases of heartburn or dumping syndrome) than that in the gastric reconstruction group. For reconstruction of the esophagus, the colonic interposition and supercharge technique is advantageous and contributes to the patient's quality of life.