Original articleGeneral thoracicSurgical Outcome of Colon Interposition by the Posterior Mediastinal Route for Thoracic Esophageal Cancer
Section snippets
Patients and Methods
This retrospective study was reviewed and approved by our Institutional Review Board; individual patient consent was waived. Between 1989 and August 2006, 578 consecutive patients with thoracic esophageal cancer underwent right transthoracic esophagectomy with extensive lymph node dissection at Akita University Hospital. Of the 43 patients (7.4%) who underwent esophageal reconstruction using long-segment colon interposition, 34 (79%) were reconstructed by pulling up the colon by the posterior
Results
The operations took an average of 723 ± 132 minutes, and blood losses averaged 1,056 ± 621 mL (means ± SD). The colon conduits were transposed by the posterior mediastinal route and consisted of left colon segments (transverse-descending colon) in 4 cases and right colon segments in 30 cases (25 ascending-transverse colons, 2 cecum-transverse colons, 3 ileum-transverse colons; Table 3,Fig 1). In only 2 cases, both right colon conduits, was augmentation of the distal arterial supply using a
Comment
We have shown that long-segment colon interposition by the posterior mediastinal route can be performed with no operative mortality and at low risk. In our series, there were no instances of colon necrosis, a 9% incidence of anastomotic leakages, which were cured without surgical treatment, no late redundancy, and good late alimentary function. Thus, colon interposition by the posterior mediastinal route provides good outcomes that compare favorably with esophageal reconstruction by other
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