title: [Supercharged ileocoloplasty: an option for complex oesophageal reconstructions].
abstract: BACKGROUND
  Oesophageal reconstruction in a second time is a complex surgical operation which, in some cases, requires combining microvascular techniques to increase vascular flow to the conduit. "Supercharged" ileocoloplasty allows creation of a longer conduit that makes it possible to replace the entire oesophagus. We describe our initial experience with this technique for the total reconstruction of the oesophagus.
  
  
  METHODS
  A retrospective review of the period from October 2007 to December 2009 identified 4 patients on whom a deferred oesophageal reconstruction was performed with a "supercharged" ileocoloplasty. The indications of this technique, morbidity and mortality, as well as functional results during follow up were evaluated.
  
  
  RESULTS
  The indications of this technique were: previous failure of a left colon interposition (1), oesophageal disconnection due to a gastro-pleural fistula (1), total oesophagogastrectomy (1) and partial oesophagogastrectomy (1) due to the ingestion of caustic substances, respectively. Gastrointestinal complications were the most frequent. Two cervical fistulas were diagnosed which were resolved with an absolute diet, antibiotic therapy and enteral nutrition. There was no mortality. After a median follow up of 14.7 months, two patients were nourished exclusively by mouth, one by a mixed route (oral-enteral) and another exclusively by the enteral route due to an oesophageal stenosis 11 centimetres from the dental arch; this patient required dilations and is awaiting a jejunal graft.
  
  
  CONCLUSIONS
  "Supercharged" ileocoloplasty is a complex treatment option for the total reconstruction of the oesophagus when no other alternatives are available. Postoperative morbidity is significant but the functional results are good.
authors.affiliation: Unitat de Cirurgia Esofagogàstrica, Servei de Cirurgia General i Aparell Digestiu, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. lfarran@aecirujanos.es
authors.forename: Leandre
authors.initials: L
authors.lastname: Farran Teixidor
authors.forename: Joan Maria
authors.initials: JM
authors.lastname: Viñals Viñals
authors.forename: Mónica
authors.initials: M
authors.lastname: Miró Martín
authors.forename: Carmen
authors.initials: C
authors.lastname: Higueras Suñé
authors.forename: Carla
authors.initials: C
authors.lastname: Bettónica Larrañaga
authors.forename: Humberto
authors.initials: H
authors.lastname: Aranda Danso
authors.forename: Anna
authors.initials: A
authors.lastname: López Ojeda
authors.forename: Antoni
authors.initials: A
authors.lastname: Rafecas Renau
mesh_terms: D000368:Aged; D003106:Colon / Q000098:blood supply / Q000637:transplantation*; D013505:Digestive System Surgical Procedures / Q000379:methods; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies