Reconstruction of Upper Gastrointestinal Tract with Colon Segments After Esophagogastrectomy

Abstract

Dissatisfaction with the established methods of reestablishing intestinal continuity following esophagogastrectomy or total gastrectomy has led to a search for improved methods. The operation designed for complete eradication of malignant disease results in postoperative morbidity. Inability to eat normally renders adequate nutrition difficult, owing to lack of a food reservoir. Our satisfaction with the use of the colon as an esophageal substitute¹³ led us to investigate the use of this portion of the bowel to replace the stomach. It is the purpose of this paper to present observations on 12 patients in whom a portion of the transverse colon has been used to establish esophagoduodenal continuity following esophagogastrectomy and total gastrectomy. Operative Technique Preoperative preparation consisted of restoration of nutrition and chemical balance and sterilization of the colon. The former was generally accomplished by tube feeding and intravenous electrolyte administration. The colon was prepared for two to four days