Replacement of the oesophagus with a segment of colon experience of 30 cases and technical considerations.

Thirty consecutive patients who underwent oesophageal replacement with a segment of colon (16 for malignant and 14 for benign disease) were reviewed. The operation was done in one stage in 28 cases and in two stages in two. The interposed colon was always placed isoperistaltically, in the bed of the oesophagus in 24 and retrosternally in 6 cases. In seven patients a valve was constructed to prevent gastrocolic reflux. There was one early postoperative death (3%). Early non-fatal complications occurred in 5 (17%), and late complications in 6 patients (20%). The functional results were excellent to good in 21 (73%), acceptable in 7 (24%), and poor in 1 (3%). The data suggest that colonic interposition offers a good alternative to stomach in selected cases with oesophageal malignancy and represents an excellent choice for reconstruction in benign oesophageal disease.