Colon Interposition for Esophageal Bypass or Replacement

The purpose of this report is to review the indications, limitations, and complications of colon interposition for replacing or bypassing the esophagus. We wish to present its uses in benign and malignant conditions, in both children and adults. Esophageal reconstruction using the colon was described in the early 1900's utilizing an antethoracic subcutaneous route,1,2but Ochsner in 1934, in reviewing esophagoplasties, reported only 20 instances of subcutaneous colon transplantations between 1911-1934.3The use of the colon for an esophagus has been developed further as better methods of bowel preparation and other aids became available; successful esophageal reconstruction with colon segments have been reported with increasing frequency.4-12 Our experience being reported upon from The Wisconsin Medical Center rests with 17patients, all treated by retrosternal colon interposition. Indications The indications for colon interposition are for conditions (Table 1) of progressive esophageal obstruction, certain instances of congenital esophageal atresia