Colon Interposition in the Treatment of Carcinoma of the Esophagus and Gastric Cardia

• Published in: The Annals of thoracic surgery Vol. 43; no. 4; pp. 420 - 424
• Main Authors: Isolauri, Jouko, Markkula, Hannu, Autio, Ville
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1987; Elsevier Science
• Subjects: Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - surgery; Cardia - surgery; Colon - transplantation; Esophageal Neoplasms - surgery; Esophagus; Esophagus - surgery; Female; Gastrectomy; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hypopharyngeal Neoplasms - surgery; Male; Medical sciences; Middle Aged; Pharyngeal Neoplasms - surgery; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Stomach Neoplasms - surgery; Thoracic Surgery; Tumors; Human; Surgical interposition; Stomach; Surgery; Cardia; Digestive diseases; ENT disease; Tumor; Colon; Esophagus
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/S0003-4975(10)62819-6

The stomach is the organ most used for restoring esophageal continuity after esophageal resection for malignancy. In the present series, we report our experience over a 20-year period (1965 through 1984) with an alternative method, colon interposition. Two hundred forty-eight patients (124 men and 124 women) underwent colon interposition. Seventy-one percent (175) of the tumors were squamous cell carcinomas, and 23% (58) were adenocarcinomas in the gastric cardia and lower esophagus. The left colon was the substitute of first choice and was used in 54% of the patients. Of the interpositions, 59% were antiperistaltic. Esophagectomy without thoracotomy was the method in 146 patients. The operative mortality was 16% (40 patients), and 3% (8 patients) sustained colon graft necrosis. Leakage in the upper anastomosis occurred in 4% (10). No dysphagia was experienced by 85%, 80%, and 76% of the patients during reexaminations 3, 6, and 12 months, respectively, after operation. The 1-year and 5-year survival for patients with squamous cell carcinoma was 40% and 10%, respectively, and for patients with adenocarcinoma, 50% and 12%, respectively. The data from this study suggest that colon interposition offers a good alternative for long-term relief of dysphagia in patients with carcinoma of the esophagus. The rate of complications is acceptable.