HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Neville, W. E. Articles by Najem, A. Z. Search for Related Content PubMed PubMed Citation Articles by Neville, W. E. Articles by Najem, A. Z.

The Annals of Thoracic Surgery, Vol 36, 626-633, Copyright © 1983 by The Society of Thoracic Surgeons

ARTICLES

Colon replacement of the esophagus for congenital and benign disease

WE Neville and AZ Najem

Over the past 28 years, one of us (W. E. N.) has reconstructed the esophagus with the right colon for congenital and benign disease in 84 patients. The first patient in the series, who was operated on in 1955, remains asymptomatic. Nine patients had congenital tracheoesophageal fistula with atresia; 4, esophageal varices; 30, advanced obliterative esophagitis; and 23, corrosive destruction. In 7, severe esophagitis followed esophagogastrectomy; 4 had unsuccessful operations for achalasia; and 7 had colon bypass following esophageal perforation. Eleven early nonfatal complications occurred. Late nonfatal complications were seen in 6 patients. There were 4 early deaths (4%): following dehiscence of an intrathoracic esophagocolic anastomosis and 1 due to peritonitis. Four individuals died over the years, and 5 patients were lost to follow-up. The late results in 71 patients show that 60 (84.5%) believe they have a satisfactory result. Nine (13%) individuals are symptomatic, and 2 (2.8%) must be classified as failures. Early complications have been minimized by using preoperative intestinal angiography, anastomotic stapling techniques, and the Doppler study intraoperatively to prognosticate colon blood flow. Several important observations have been made: anastomosis in the neck is preferable; the transplanted colon dilates from loss of motor activity but is functionally adequate; an isoperistaltic segment is preferable, but an antiperistaltic implant suffices; colonic mucosa is relatively resistant to acid-peptic digestion; and hyperalimentation is mandatory in very ill and debilitated patients.

This article has been cited by other articles:

				K. A. Mansour, F. C. Bryan, and G. W. Carlson Bowel Interposition for Esophageal Replacement: Twenty-Five-Year Experience Ann. Thorac. Surg., September 1, 1997; 64(3): 752 - 756. [Abstract] [Full Text]