Esophageal reconstruction by colon interposition after esophagectomy for XXXX analysis of current indications, operative outcomes, and long-term survival.

@entity1 @entity39 @entity5 @entity354 @entity356
INTRODUCTION: Colon interposition is an alternative solution for esophageal reconstruction if the stomach cannot be used. The study reviews current indications and results of coloplasty for @entity5 . METHODS: @entity1 who underwent colon interposition for gastro-esophageal malignancy were included. Primary coloplasty was defined as upfront colon interposition. Salvage coloplasty was defined as colon interposition after primary reconstruction failure. Mortality, morbidity, function, and survival were evaluated. RESULTS: We included 28 @entity1 (24 @entity1 , median age 61   years). Ten (36%) @entity1 underwent primary coloplasty due to previous gastrectomy (n   =   5), conduit @entity356 (n   =   2), extensive @entity354 (n   =   2), and @entity356 recurrence (n   =   1). Salvage coloplasty was performed in 18 (64%) @entity1 for postoperative graft @entity39 (n   =   5) and intractable strictures (n   =   3). Operative mortality, morbidity, and graft @entity39 rates were 14% (4/28), 86% (24/28), and 14% (4/28), respectively; there were no significant differences between primary and salvage coloplasty. Survival rates at 1-, 3-, and 5 years were 81%, 51%, and 38%, respectively. Survival was decreased after primary coloplasty when compared to salvage coloplasty (P   =   0.03). Nine @entity1 experienced @entity5 recurrence (primary: n   =   6, salvage: n   =   3) after coloplasty and eight of them died. CONCLUSION: Colon interposition after esophagectomy is a useful but morbid endeavor. Colon interposition as salvage therapy is associated with improved survival compared to its use as primary esophageal replacement, and colon interposition in the latter cohort should be used with caution due to poor @entity5 -specific survival in this @entity1 population. J. Surg. Oncol. 2016;113:159-164.    2015 Wiley Periodicals, Inc.
