Internal mammary blood supply for ileo-colon interposition in esophagogastroplasty: A case report

We report on a clinical case where microsurgical techniques successfully su pported traditional surgery in a wide reconstruction between the oropharynx and small bowel. Several years ago, the patient sustained a severe corrosi ve injury of the upper digestive tract with subsequent esophageal stricture and stiffening; at that time, an emergency gastrectomy was performed. In t his case, the restoration of the defect could not rely on the classic colon ic interposition. During the operation the ileo-colic flap, well-fitted for tension-free reconstruction, revealed the foreseen inadequacy of its vascu larization based on the sole middle colic vascular pedicle. The blood suppl y to its proximal part was then increased by microanastomosis between the r ight internal mammary and ileo-colic vessels. The revascularization ensured the viability of the interposed tissue. Oral intake resumed after 3 weeks; nowadays the patient is able to maintain her ideal weight with adequate nu trition. (C) 1998 Wiley-Liss, Inc.