LONG-TERM FUNCTIONAL RESULTS AND QUALITY-OF-LIFE AFTER COLON INTERPOSITION FOR LONG-GAP ESOPHAGEAL ATRESIA

Out of a series of 146 patients with oesophageal atresia 9 (6.2%) unde rwent colon interposition from 1963 to 1971. AU eight surviving patien ts were seen at follow-up after a mean of 22 years. Three patients wer e free of specific symptoms according to the criteria of DeMeester, tw o had moderate and three severe distress. The mean time for consuming a standardized test meal was 15 minutes, compared to 8 minutes in heal thy controls. Patients required 1-9 minutes to transport liquid barium through the transplant, compared to <10 seconds in control subjects. Histological evaluation revealed a normal architecture of the colonic and ileal epithelium in three patients who underwent endoscopy. In non e of these patients were contractions in the colon graft related to th e act of swallowing recorded on manometry. Unimpaired quality of life was indicated by the Spitzer index which scored a mean of nine out of ten points. However, on a 100 point visual analogue scale patients sco red their global quality of life 66 and the mean Gastrointestinal Qual ity of Life Index was 92.2, compared to 107.6 in healthy control subje cts (p<0.05). This impairment was exclusively due to specific symptoms which scored 49.3 in patients and 59 in healthy individuals (p<0.05). Physical and social functions, emotions, and inconvenience of a medic al treatment were similar to control subjects. We conclude that colon interposition for long-gap oesophageal atresia achieves acceptable lon g-term functional results. However, specific symptoms lead to a consid erable impairment in quality of life.