Colon substitution after esophagectomy for cancer. Retrospective study of morbidity and mortality.

Aim of this study has been to evaluate retrospectively morbidity and mortal ity of 42 colon substitutions after resection for esophageal cancer. Colon substitution was the intervention of first choice in six patients. In the o ther patients the stomach was useless, because of previous gastric surgery (n = 14), of gastric involvement by the tumor (n = 21) or technical problem (n = 1). Patients have been separated in 2 groups: from 1969 to 1983 (grou p A, n = 22), and from 1983 to 1997 (group B, n = 20). Mortality and morbid ity tall eventful postoperative course) have been collected for the 30 post operative days. Total morbidity has been 57% as 77% in group A and 35% in g roup B (p < 0,05). Cervical and cole-colic leak have been the most common c omplications. Total mortality has been 14% as 22% in group A and 5% in grou p B (p < 0,1). In group A 3 patients died from anastomosis leak (intrathora cic or intraabdominal) and 2 from medical complications. In group B 1 patie nt died from unexplained sepsis. Our results show significative decrease of morbidity and mortality in group B. These results can be compared to those of gastroplasty for cancer or coloplasty for benign disease. In cancer of the esophagus, if stomach can not be used as substituteis, colon substituti on is the best alternative, which can be used without increase of mortality and morbidity.