Guo Bin, He Ming, Zhao Jidong, Ma Minting, Gao Zhanjie
Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Medical Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Front Surg. 2023 Jan 30;10:1098583. doi: 10.3389/fsurg.2023.1098583. eCollection 2023.
Colon interposition is a complex and time-consuming procedure requiring at least three or four digestive anastomoses. However, the long-term functional outcomes are promising, with an acceptable operative risk.
Herein, two cases of esophageal carcinoma that received esophagus reconstruction using the distal continual colon interposition technique have been described. The transverse colon was lifted to the thoracic cavity for the end-to-side anastomosis with the esophagus, and a closure device was used to close the colon instead of severing and isolating the distal end. The duration of the operation was 140 and 150 min, respectively. The blood supply of the colon was maintained during the intervention. The tension-free anastomosis was performed without severe complications, and oral food intake was resumed on postoperative day 6. Neither anastomotic stenosis, antiacid or heartburn, dysphagia, or emptying obstacles nor complaints of diarrhea, bloating, or malodor were reported during the follow-up period.
The modified distal-continual colon interposition technique may have the advantages of a short operation time and potential prevention of serious complications caused by the torsion of mesocolon vessels.
结肠间置术是一种复杂且耗时的手术，至少需要进行三到四次消化吻合。然而，其长期功能结果令人满意，手术风险可接受。
本文描述了两例采用远端连续性结肠间置技术进行食管重建的食管癌病例。将横结肠提升至胸腔与食管进行端侧吻合，使用闭合装置闭合结肠而非切断并分离远端。手术时间分别为140分钟和150分钟。干预过程中结肠血供得以维持。进行了无张力吻合，未出现严重并发症，术后第6天恢复经口进食。随访期间未报告吻合口狭窄、反酸或烧心、吞咽困难、排空障碍，也未出现腹泻、腹胀或异味等主诉。
改良的远端连续性结肠间置技术可能具有手术时间短以及潜在预防结肠系膜血管扭转引起的严重并发症的优点。
