Elsevier

The Annals of Thoracic Surgery

Volume 92, Issue 6, December 2011, Pages e113-e114
The Annals of Thoracic Surgery

Case report
Adenocarcinoma in a 40-Year-Old Colonic Interposition Treated With Ivor Lewis Esophagectomy and Esophagogastric Anastomosis

https://doi.org/10.1016/j.athoracsur.2011.06.025Get rights and content

Colon interposition for benign stricture is associated with significant perioperative complications that carry high morbidity and mortality, but long-term sequelae such as further strictures and colonic redundancy are often well-tolerated. These benign complications are frequently described in literature, but adenocarcinoma in the colonic graft is a rare complication. We describe a 60-year-old man with a history of benign esophageal stricture who was treated with colon interposition 40 years ago and presented with dysphagia secondary to stage 1 colon graft adenocarcinoma. He was successfully treated with an Ivor Lewis esophagectomy and primary esophagogastric anastomosis.

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Comment

Colonic interposition is a technical, challenging operation for esophageal replacement that has become a secondary option to gastric pull-up, followed in preference by jejunal graft, Roux-en-Y esophagojejunostomy, or creation of a permanent salivary fistula with feeding jejunostomy. In a large series of 393 patients undergoing consecutive esophagectomies, Briel and colleagues [1] compared complications of gastric pull-up and colonic interposition, reporting a statistically similar incidence of

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    Citation Excerpt :

    The current case emphasizes the possibility of the development of a neoplasia when a colonic conduit is used. For patients with a colonic interposition graft, screening of the colonic graft 2 years after the esophageal surgery has been suggested.10 Subsequent endoscopic surveillance is recommended on a 2- to 3-yearly basis owing to the possibility of a development of a polyp or a colonic malignancy.

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