Background. Long-segment colon interposition has been used for esophageal r
eplacement for acquired esophageal disease. The indications for use, morbid
ity, and functional results of these conduits have been debated.
Methods. We reviewed the medical records, office visits, and operative repo
rts of patients undergoing long colon interposition for acquired esophageal
disease at our institution from 1956 to 1997.
Results. Long colon interposition was performed in 52 patients for caustic
injury (n = 20), gastroesophageal disease (n = 16), previous irradiation (n
= 8), primary motility disorders (n = 4), and acquired absence of the esop
hagus (n = 4). From 1976 to 1997, acquired diseases accounted for 62% of lo
ng colon interposition. The left colon was used in 46 patients and the righ
t colon in 6. The in-hospital mortality rate was 4%. Early complications in
cluded graft ischemia in 5 patients, anastomotic leak in 3, and small bowel
obstruction in 1. Late complications included anastomotic stenosis requiri
ng dilation in 26 patients, with 2 requiring surgical revision, and bile re
flux requiring surgical diversion in 1 patient. Swallowing function was exc
ellent in 24% of patients, good in 66%, and poor in 10%.
Conclusions. Long colon interposition can be performed safely, with accepta
ble long-term functional results in patients with acquired esophageal disea
se. (C) 1999 by The Society of Thoracic Surgeons.