Advanced adenocarcinoma in a colonic interposition segment

Aryal, Madan Raj; Mainali, Naba Raj; Jalota, Leena; Altomare, John

doi:10.1136/bcr-2013-009749

Cited by 11 publications

(15 citation statements)

References 21 publications

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“…Because interval lesions are typical late complications and the risk increases over a longer time after index surgery, a life-long endoscopic follow-up must be postulated. In addition, the individual risk can be assessed by anamnestic factors such as colitis, history of colonic polyps, positive family history for colonic carcinoma (43). Positive information should lead to a closer follow-up interval.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Polyps and Adenocarcinoma in Colon Interposition After Esophagectomy in Adulthood – A Systematic Review

et al. 2019

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Background/Aim: Colon interposition counts among the most common techniques for reconstruction after esophagectomy. Availability of data on metachronous mucosal pathologies is weak. The aim of this review was to identify all reports on the development of metachronous adenoma and adenocarcinoma in colon interposition after esophagectomy in adulthood. Materials and Methods: A comprehensive search was conducted in MEDLINE/PubMed, Science Direct, Cochrane Library, Bayerische Staatsbibliothek München. All studies reporting on patients who received colon interposition as substitute after esophagectomy in adulthood for benign and malignant reasons were included. Results: Five retrospective studies were included, reporting on 1016 patients. Therein, no interval lesion was identified. One further study, which formally must be excluded for a misfit to inclusion criteria reports on three interval carcinomas within 365 patients. Because these lesions were the only ones found within a cohort analysis, results were supplementary reported in this review. Additionally, 31 case reports including 32 patients with benign (n=7) or malignant (n=25) findings were analyzed. Median age was 63.5 years (interval carcinoma) and 69 years (benign lesion). Benign and malignant lesions were diagnosed after a median of 8.5 years. Conclusion: Due to the rareness of respective cohort studies, the frequency of metachronous lesions cannot be calculated accurately. The estimated rate of interval carcinoma is 0-0.22%. Life-long endoscopic surveillance of patients with colon interposition is recommended.Esophagectomy with replacement by colon interposition was first described by Kelling and Vuillet in 1911 (1, 2). Since then, the colon developed into the most commonly used esophageal substitute if the stomach is not available for reconstruction (3). The majority of patients undergoing esophagectomy with colon interposition for malignant disease are older than 55 years and thereby at risk for the development of colonic polyps. Further, patients with adenocarcinoma of the esophagus showed a significantly higher risk for the occurrence of colonic polyps (4). Patients, who receive the interposition procedure for benign pathologies are relevantly younger in common, therefore their lifetime risk for the development of mucosal changes in the substitute is relatively higher. To date, no systematic review focuses on the rate of mucosal changes such as adenoma and adenocarcinoma in colon interposition in adulthood.

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Section: Discussionmentioning

confidence: 99%

Frequency of Polyps and Adenocarcinoma in Colon Interposition After Esophagectomy in Adulthood – A Systematic Review

et al. 2019

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“…It is important to undergo colonoscopy before surgery to rule out pre-existing polyps, extensive diverticulosis and malignancy which are contra-indications for the interposition [ 1 ]. The left colon is preferred for the transposition due to its smaller diameter, but right colon or transverse colon interpositions are performed as well [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Colonic interposition in oesphageal replacement after oesophagectomy is a procedure practiced for the management of both benign and malignant diseases of the oesophagus, particularly when gastric pull-up is not feasible, and its associated with significant perioperative complications that carry hight morbidity and mortality [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Adenocarcinoma arising in a colonic interposition after esophagectomy for benign stricture and review of the literature

Barbosa

Santos

Mesquita

et al. 2018

Journal of Surgical Case Reports

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Colon interposition in oesophageal replacement after oesophagectomy for benign strictures is associated with significant perioperative complications that carry high morbidity and mortality. Long-term sequelae such as further strictures and colonic redundancy are frequent. Adenocarcinoma in the colonic graft is rare. A 70-year-old female presented to our clinic with symptoms of dysphagia. When she was 51 years, she underwent left colonic oesophageal interposition for an oesophageal stricture caused by caustic ingestion. Studies revealed colonic adenocarcinoma in interposed colonic graft, with latero-cervical lymph nodes. She was proposed to neoadjuvant chemotherapy. Although long-term risk analysis is lacking, it’s not unreasonable to propose endoscopic screening according to general colonic cancer guidelines in patients with colonic interposition in oesophageal replacement after oesophagectomy.

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“…This case serves as a reminder of the importance of colon interposition screening. Furthermore, in the review of literature (Table 1) [14,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]], 15 out of 22 patients have developed adenocarcinoma in the grafted interposed colon. This could have been prevented if the patients had regular EGD screening or surveillance follow-up.…”

Section: Discussionmentioning

confidence: 99%

Tubular Adenomatous Polyp in a Colon Interposition: A Case Report and Review of Literature

2015

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Esophagectomy with colon interposition is a technique used for the replacement of a diseased esophagus. Since segments of the colon are used in this procedure, clinicians must be aware that a variety of pathologies can arise from colonic interposition. Therefore, patients who undergo this procedure and are due for a screening or surveillance colonoscopy must also get a screening or surveillance upper endoscopy to examine the interposed colon. We report a case of a 59-year-old male who had a history of Barrett's esophagus with high grade dysplasia successfully treated with colon interposition. Upper endoscopy showed a tubular adenomatous polyp of the colonic segment.

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Advanced adenocarcinoma in a colonic interposition segment

Abstract: SUMMARYAlthough rarely reported in the literature, adenomatous polyp and adenocarcinoma can occur as a late complication in an interposed colonic segment. We describe a case of a late stage adenocarcinoma in a colonic interposition performed for benign oesophageal stricture. BACKGROUND

Cited by 11 publications

References 21 publications

Frequency of Polyps and Adenocarcinoma in Colon Interposition After Esophagectomy in Adulthood – A Systematic Review

Frequency of Polyps and Adenocarcinoma in Colon Interposition After Esophagectomy in Adulthood – A Systematic Review

Adenocarcinoma arising in a colonic interposition after esophagectomy for benign stricture and review of the literature

Tubular Adenomatous Polyp in a Colon Interposition: A Case Report and Review of Literature

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