Year 2019 Vol. 27 No 2




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.

Keywords: esophageal carcinoma, gastroesophageal junction carcinoma, repeated esophageal replacement by colon interposition, retrosternal route of graft translocation, discontinuity procedure, esophageal demucosation
p. 177-187 of the original issue
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Address for correspondence:
223040, The Republic of Belarus,
Minsk region, Lesnoy 2,
N.N. Alexandrov National Cancer
Centre of Belarus,
Surgical Department.
Tel. office.: 8 017 389 95 32,
Ilya A. Ilyin
Information about the authors:
Ilyin Ilya A., PhD, Leading Researcher of the Surgical Department, N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus.
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