European perspective in Thoracic surgery—eso-coloplasty: when and how?

Abstract

Colon interposition has been used since the beginning of the 20(th) century as a substitute for esophageal replacement. Colon interposition is mainly chosen as a second line treatment when the stomach cannot be used, when the stomach has to be resected for oncological or technical reasons, or when the stomach is deliberately kept intact for benign diseases in young patients with long-life expectancy. During the surgery the vascularization of the colon must be carefully assessed, as well as the type of the graft (right or left colon), the length of the graft, the surgical approach and the route of the reconstruction. Early complications such as graft necrosis or anastomotic leaks, and late complications such as redundancy depend on the quality of the initial surgery. Despite a complex and time-consuming procedure requiring at least three or four digestive anastomoses, reported long term functional outcomes of colon interposition are good, with an acceptable operative risk. Thus, in very selected indications, colon interposition could be seen as a valuable alternative for esophageal replacement when stomach cannot be considered. This review aims at briefly defining "when" and "how" to perform a coloplasty through demonstrative videos.

Tissue Engineered Esophageal Patch by Mesenchymal Stromal Cells: Optimization of Electrospun Patch Engineering

“…There are several conditions, both congenital and acquired (malignant or benign tumor, in some forms of atresia, caustic lesion, and severe reflux), for which esophageal replacement is needed [1]. The surgical intervention remains the preferred treatment, however alternative options are essential for restoring esophageal continuity and functionality [2][3][4][5]. These alternative approaches may be associated with several complications, such as inflammatory response, scar deposition, stricture formation, and in the most serious cases, they could cause the morbidity of surrounding tissues [6].…”

Preliminary Use of Indocyanine Green Fluorescence Angiography and Value in Predicting the Vascular Supply of Tissues Needed to Perform Cloacal, Anorectal Malformation, and Hirschsprung Reconstructions

“…7,8 Anatomic variations are frequent, and aberrations such as absence of the middle colic artery or inadequate vascularization of the splenic flexure are frequent (up to 25%). 9,10 Adequate vascular supply is paramount in the pediatric colorectal surgical patient in whom colonic pedicles are used. In ARM, the pulled through rectum is perfused by the inferior mesenteric artery (IMA) blood supply with intramural blood flow.…”

Laparoscopic retrosternal gastric pull-up for fistulized mediastinal mass

“…Colon interposition is the first choice for selected patients with esophageal cancer when the stomach is unavailable or for benign esophageal diseases especially in young patients, with the intent of preserving the stomach[10]. Although long-term results for coloplasty are similar to gastroplasty, the reconstruction with the stomach generally involves a simpler operation with only one anastomosis[11].…”