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03.06.2022 | original article

A renovated method of performing over 258 cases of pedicled colon segment interposition for esophageal reconstruction with integration of plastic surgery principles into general surgery procedure

verfasst von: MD, PhD Associate Professor Burak Kaya, MD, PhD Shih-heng Chen, MD, PhD, FACS Professor Hung-chi Chen

Erschienen in: European Surgery

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Summary

Background

In the field of reconstruction, there is always room for improvement of results regarding safety, functions, esthetics, and a decrease in complications and morbidities. A complex procedure such as conventional colon segment interposition for esophageal reconstruction can be improved by integrating plastic surgery principles.

Methods

A retrospective study was carried out. Esophagectomies are performed due to malignant diseases such as squamous cell carcinoma of the esophagus and hypopharynx, or benign conditions such as caustic injuries. From 1983 to 2018, a renovated method of colon segment interposition was developed and performed under the collaboration of plastic and general surgeons. It included the following features: 1. skin incision at the neck; 2. identification of the recurrent laryngeal nerve and superior laryngeal nerve; 3. stent placement across the proximal anastomotic site; 4. use of a diversion loop when there is damage of the epiglottis; 5. instruments to create a wide substernal tunnel; 6. supercharge of vessels at the neck to augment the blood supply of the colon segment, indicated in patients with arteriosclerosis and anatomical variation of the colon due to congenital variation or following abdominal trauma; 7. use of a seromuscular flap; 8. use of intraluminal and extraluminal drains at the neck.

Results

In the 258 cases, there was no failed reconstruction, no hoarseness due to nerve damage, and only 2 patients with leakage, which was repaired secondarily. Average follow-up was 8.3 years. Average time to oral intake after completion of reconstruction was 20.4 days.

Conclusion

Brainstorming and collaboration among different subspecialties may lead to solutions for complex problems or improvement of a surgical procedure. To avoid complications of colon segment interposition, the eight steps mentioned above should be highlighted.
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Metadaten
Titel
A renovated method of performing over 258 cases of pedicled colon segment interposition for esophageal reconstruction with integration of plastic surgery principles into general surgery procedure
verfasst von
MD, PhD Associate Professor Burak Kaya
MD, PhD Shih-heng Chen
MD, PhD, FACS Professor Hung-chi Chen
Publikationsdatum
03.06.2022
Verlag
Springer Vienna
Erschienen in
European Surgery
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-022-00766-8