[Reconstruction of the cervical esophagus by interposition of the transverse colon].
Currently, the first choice viscus for reconstruction after total pharyngolaryngoesophagectomy is a jejunal interposition. This requires at least one end-to-side anastomosis in the pharyngo-jejunal anastomosis, esophago-jejunal anastomosis, or both due to the small diameter of the jejunum and round shape of the mesenterium. Furthermore, the jejunal graft experiences a spasm when the patient swallows. For such reasons the jejunal free graft is not suitable for swallowing. On the other hand, the transverse colon graft is more appropriate for reconstruction for the following reasons: it has a straight shape; end-to-end anastomosis is possible to both the pharynx and esophagus; and there are postoperative complications due to simple anastomosis of the remaining colon after graft removal. Blood vessel anastomoses, performed using microsurgery techniques, are followed by esophageal reconstructive anastomoses. Fifteen patients successfully underwent this type of reconstruction in our institution.
Noguchi
T
T
Department of Surgery II, Oita Medical University, Oita, Japan.
Uchida
Y
Y
Hashimoto
T
T
Wada
S
S
Suko
T
T
Suzuki
M
M
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000637:transplantation*; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery; D011182:Postoperative Care