Gust Lucile, Ouattara Moussa, Coosemans Willy, Nafteux Philippe, Thomas Pascal Alexandre, D'Journo Xavier Benoit
1 Department of Thoracic Surgery, North Hospital, Aix-Marseille University, Marseille, France ; 2 Department of Thoracic Surgery, University Hospital Campus Gasthuisberg KUZ Leuven, Leuven, Belgium.
J Thorac Dis. 2016 Apr;8(Suppl 4):S387-98. doi: 10.21037/jtd.2016.04.43.
Colon interposition has been used since the beginning of the 20(th) century as a substitute for esophageal replacement. Colon interposition is mainly chosen as a second line treatment when the stomach cannot be used, when the stomach has to be resected for oncological or technical reasons, or when the stomach is deliberately kept intact for benign diseases in young patients with long-life expectancy. During the surgery the vascularization of the colon must be carefully assessed, as well as the type of the graft (right or left colon), the length of the graft, the surgical approach and the route of the reconstruction. Early complications such as graft necrosis or anastomotic leaks, and late complications such as redundancy depend on the quality of the initial surgery. Despite a complex and time-consuming procedure requiring at least three or four digestive anastomoses, reported long term functional outcomes of colon interposition are good, with an acceptable operative risk. Thus, in very selected indications, colon interposition could be seen as a valuable alternative for esophageal replacement when stomach cannot be considered. This review aims at briefly defining "when" and "how" to perform a coloplasty through demonstrative videos.
自20世纪初以来，结肠代食管术就被用作食管替代的方法。当不能使用胃时，当出于肿瘤学或技术原因必须切除胃时，或者当年轻且预期寿命长的患者因良性疾病而有意保留胃完整时，结肠代食管术主要被选作二线治疗方法。在手术过程中，必须仔细评估结肠的血供，以及移植物的类型（右半结肠或左半结肠）、移植物的长度、手术入路和重建路径。早期并发症如移植物坏死或吻合口漏，以及晚期并发症如冗余，取决于初始手术的质量。尽管该手术复杂且耗时，至少需要进行三到四次消化道吻合，但报道的结肠代食管术的长期功能结果良好，手术风险可接受。因此，在非常特定的适应症中，当不能考虑使用胃时，可以将结肠代食管术视为食管替代的一种有价值的选择。本综述旨在通过演示视频简要界定进行结肠成形术的“时机”和“方法”。
