ArticleLangenbeck's archives of surgery2026
Colon interposition after esophagectomy: a 15-year single-center experience.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundColonic interposition is the preferred option for alimentary tract reconstruction when a gastric conduit pull-up is not feasible. Aim of this study was to evaluate perioperative outcomes of patients undergoing colonic interposition for various indications in our tertiary-care center over a 15-year period.
methodsFollowing institutional board approval, all consecutive patients who underwent colonic interposition for esophageal replacement were identified from a prospectively maintained database. Comprehensive chart review and descriptive statistical analyses were performed.
resultsNinety-three patients (62 men, 31 women, median age 65 years, IQR 55.5-72) underwent colonic interposition between January 2009 and December 2023. Benign disease was present in 17.2%, whereas malignancy accounted for 82.8%. A hand-sewn cervical anastomosis was performed in 96.8% of patients. The colonic graft, predominantly based on the left colic artery (89.2%) was routed through the posterior mediastinum in 51.6% and via the retrosternal route in 47.3%. Median operative time was 303 min (IQR 247.5-364). Major complications included anastomotic leakage (28%), anastomotic stenosis (30.1%), pleural empyema (11.8%), and postoperative bleeding (10.8%). The reoperation rate was 38.7%, with a median hospital stay of 29 days (IQR 20-63). In-hospital mortality was 18.3%.
conclusionColonic interposition after esophagectomy is associated with substantial morbidity and mortality, particularly in the salvage and secondary reconstruction setting, and should be confined to experienced, high-volume centers. CLINICAL REGISTRATION NUMBER: FMS_D_007.23-I-1.
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