Operative outcome of colon interposition in the treatment of esophageal cancer: A 20-year experience

The role of preoperative angiogram in colon interposition surgery

“…Our postsurgical complication rates of graft necrosis (6.2%), anastomotic leak (12.5%), and anastomotic stricture (18.7%) were similar to those previously reported (Table 3) (1,3,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Of these studies, five (including ours) routinely used preoperative angiography in all or a defined select group of patients, two did not use routine preoperative angiography, and six did not report whether preoperative angiography was used. The rate of graft necrosis ranged from 3% to 5% in those who did not routinely perform preoperative angiography; 3% to 9.6% in those who did perform angiography in all or a predefined select group of patients; and 0% to 9% in those who did not report if they did or did not perform angiography.…”

Esophageal and Esophagogastric Junction Cancers

“…58 Colon interposition is usually reserved for patients who have undergone previous gastric surgery or other procedures that might have devascularized the stomach. 59 Ivor Lewis esophagogastrectomy (right thoracotomy and laparotomy) and the McKeown esophagogastrectomy (right thoracotomy followed by laparotomy and cervical anastomosis) are the 2 standard options to achieve transthoracic esophagogastrectomy. Ivor Lewis esophagogastrectomy, the most frequently used procedure for transthoracic esophagogastrectomy, uses laparotomy and right thoracotomy, with upper thoracic esophagogastric anastomosis (at or above the azygos vein).…”

Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage

“…In cases with a history of gastrectomy, concurrent gastric disease, or cancer involvement of the stomach, the colon or jejunum is used instead of the stomach as an esophageal substitute. A colon graft is generally preferred over the jejunum, as it is easier to mobilize; however, debates surround the surgical procedures, mortality, morbidity, and outcomes of colon interposition for the treatment of esophageal cancer 6–24 . A notable criticism is the high rate of postoperative leakage and colon necrosis associated with this strategy.…”