This journal is
indexed in Scopus
Year 2019 Vol. 27 No 2
RESULTS OF REPEATED COLON INTERPOSITION FOR ESOPHAGEAL REPLACEMENT IN ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION IN CARCINOMA SURGICAL TREATMENT
N.N. Alexandrov National Cancer Centre of Belarus, Minsk,
The Republic of Belarus
Objective. To evaluate the results of the repeated colon interposition for esophageal replacement in the esophageal and gastroesophageal junction carcinomas surgical treatment.
Methods. Repeated colon interposition after discontinuity resections for ischemic complications of primary gastric or jejunal pull up procedures during the esophageal and gastroesophageal junction carcinomas surgical treatment was implemented in 40 patients. Squamous cell esophageal carcinoma was represented in 52.5% (21/40) observations and gastroesophageal junction adenocarcinoma — in 47.5% (19/40). Patients’ mean age was 56.0 (52.0, 63.0) years, body mass index — 21.4 (18.9, 24.5) units. Male patients predominated over females — 90% (36/40) and 10% (4/40) respectively. Repeated reconstructions were preceded by previously performed discontinuity procedures. Esophago-gastric anastomosis resection was performed in 57.5% (23/40) patients, gastric conduit removal ― in 7.5% (3/40), esophageal demucosation with complicated anastomosis resection ― in 35% (14/40).
Results. Time of procedures was 345.0 (310.0, 407.5) minutes, blood loss — 400.0 (300.0, 500.0) ml, in-hospital stay — 27.5 (21.0, 40.5) days. Esophago-colonic anastomosis leakage and/or an oral end graft necrosis were detected clinically and radiologically on the 8th day after surgery. Anastomotic leakage developed in 12.5% (5/40) observations, graft loss — in 5% (2/40). Late esophageal anastomotic strictures, determined by means of esophagocolonoscopy 3 months after the repeated esophagoplasty, were formed in 7.5% (3/40) patients. 30- and 60-day mortality rate made up 7.5% (3/40) and 10% (4/40) cases respectively. Overall 5-year survival was 26.9%.
Conclusions. Repeated colon interposition for esophageal replacement in esophageal and gastroesophageal junction carcinomas surgical treatment is a «salvage» procedure for patients who undergo discontinuity surgical interventions which allows achieving satisfactory long-term treatment outcomes.
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223040, The Republic of Belarus,
Minsk region, Lesnoy 2,
N.N. Alexandrov National Cancer
Centre of Belarus,
Tel. office.: 8 017 389 95 32,
Ilya A. Ilyin
Ilyin Ilya A., PhD, Leading Researcher of the Surgical Department, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus.