The Annals of Thoracic Surgery, Vol 32, 584-591, Copyright © 1981 by The Society of Thoracic Surgeons
Colon interposition for advanced nonmalignant esophageal stricture: experience with 40 patients
KA Mansour, HA Hansen 2d, T Hersh, JI Miller Jr and CR Hatcher Jr
This report details our experience in 40 patients with benign strictures of
the esophagus who underwent colon (or gastric) interposition with our
without esophageal resection between 1972 and 1980. There were 23 men and
17 women ranging from 5 to 76 years old. Twenty-seven patients had fibrotic
strictures secondary to reflux esophagitis including 12 after failure of
antireflux procedures; 4 had caustic strictures; 3 had a Barrett's
esophagus; 2 had systemic candidiasis; 2 had scleroderma; and in 2 the
etiology was undetermined. the right colon was used in 27 patients, the
left colon in 4, the transverse colon in 1, and the jejunum in 1. In 7
patients the stomach was employed because of vascular insufficiency of the
colon. Three surgical approaches were utilized. Manometric studies were
done post- operatively in 10 patients. Complications occurred in 7
patients: cervical leaks, 4; reflux colitis, 2; and a late cervical
stricture, 1. There were 4 deaths, only 1 of which was related directly to
technique. This report summarizes the beneficial effect of right colon
interposition for long esophageal strictures. Its vasculature is adequate,
and it functions properly to propel food into the stomach irrespective of
the peristaltic orientation.
