COLON INTERPOSITION FOR WIDE-GAP ESOPHAGEAL ATRESIA

A retrospective study covering December 1978 to December 1989 at Booth Hall Children's Hospital, Manchester, revealed that 12 colon interpos ition were performed in 11 children to reconstruct their oesophagus. A ll were for wide-gap oesophageal atresia with or without fistula. One patient underwent colon interposition twice due to ischaemia or the in itial transplant. Waterston's transthoracic procedure was used mostly with a modification by Freeman performed in one patient. Main early po stoperative complications included proximal anastomosis leak (45.5%) a nd respiratory infection (36.4%). Late complications were proximal ana stomotic stricture (22.2%); gastrointestinal problems (66.7%); and rec urrent respiratory infection (11.1%). Although colon redundancy radiol ogically was noted in two patients, they were well with no dysphagia. Mortality was 18.2%, the two patients dying suddenly two weeks after c olon transplant from pulmonary complications. At follow-up (mean: 6.2 years) growth rate had improved slightly, and 11.1% weighed above the 10th percentile. However, 77.8% could swallow satisfactorily within on e year of surgery.