BACKGROUND: Colonic interposition is a second-line option after oesophagectomy when a gastric neo-oesophagus is not viable. There is no consensus on the optimum anatomical colonic conduit (right or left), or route of placement (posterior mediastinal, retrosternal or subcutaneous). The aim of this review was to determine the optimum site and route of neo-oesophageal conduit after adult oesophagectomy. METHODS: PubMed, MEDLINE, and the Cochrane Library (January 1985 to January 2017) were systematically searched for studies which reported outcomes following colonic interposition in adults. The outcome measures were overall morbidity and mortality. RESULTS: Twenty-seven observational studies involving 1849 patients [1177 males; median age (range) 60.5 (18-84) years] undergoing colonic interposition for malignant (n = 697) and benign (n = 1152) pathology were analysed. Overall pooled morbidity of left vs. right colonic conduit was 15.7% [95% CI (11.93-19.46), p < 0.001] and 18.7% [95% CI (15.58-21.82), p < 0.001] respectively. Overall pooled mortality of left vs. right colonic conduit was 6.5% [95% CI (4.55-8.51), p < 0.001] and 10.1% [95% CI (7.35-12.82), p < 0.001] respectively. Retrosternal route placement was associated with the lowest overall pooled morbidity and mortality of 9.2% [95% CI (6.48-11.99), p < 0.001] and 4.8% [95% CI (3.74-5.89), p < 0.001] respectively. CONCLUSION: Left colonic conduits placed retrosternally were safest.
BACKGROUND: Colonic interposition is a second-line option after oesophagectomy when a gastric neo-oesophagus is not viable. There is no consensus on the optimum anatomical colonic conduit (right or left), or route of placement (posterior mediastinal, retrosternal or subcutaneous). The aim of this review was to determine the optimum site and route of neo-oesophageal conduit after adult oesophagectomy. METHODS: PubMed, MEDLINE, and the Cochrane Library (January 1985 to January 2017) were systematically searched for studies which reported outcomes following colonic interposition in adults. The outcome measures were overall morbidity and mortality. RESULTS: Twenty-seven observational studies involving 1849 patients [1177 males; median age (range) 60.5 (18-84) years] undergoing colonic interposition for malignant (n = 697) and benign (n = 1152) pathology were analysed. Overall pooled morbidity of left vs. right colonic conduit was 15.7% [95% CI (11.93-19.46), p < 0.001] and 18.7% [95% CI (15.58-21.82), p < 0.001] respectively. Overall pooled mortality of left vs. right colonic conduit was 6.5% [95% CI (4.55-8.51), p < 0.001] and 10.1% [95% CI (7.35-12.82), p < 0.001] respectively. Retrosternal route placement was associated with the lowest overall pooled morbidity and mortality of 9.2% [95% CI (6.48-11.99), p < 0.001] and 4.8% [95% CI (3.74-5.89), p < 0.001] respectively. CONCLUSION:Left colonic conduits placed retrosternally were safest.
Authors: J D Knezević; N S Radovanović; A P Simić; M M Kotarac; O M Skrobić; V D Konstantinović; P M Pesko Journal: Dis Esophagus Date: 2007 Impact factor: 3.429
Authors: Pietro Renzulli; Alexander Joeris; Oliver Strobel; Annemarie Hilt; Christoph A Maurer; Waldemar Uhl; Markus W Büchler Journal: Langenbecks Arch Surg Date: 2004-01-09 Impact factor: 3.445
Authors: Orlino C Bisquera; Anthony R Perez; Neresito T Espiritu; Ma Katrina B Guillermo; Mary Ellen Chiong Perez Journal: Int J Surg Case Rep Date: 2022-05-19
Authors: Leonie R van der Werf; Charlotte Cords; Ivo Arntz; Eric J T Belt; Ivan M Cherepanin; Peter-Paul L O Coene; Erwin van der Harst; Joos Heisterkamp; Barbara S Langenhoff; Bas Lamme; Mark I van Berge Henegouwen; Sjoerd M Lagarde; Bas P L Wijnhoven Journal: Ann Surg Oncol Date: 2019-04-22 Impact factor: 5.344
Authors: Sven Flemming; Johan F Lock; Mohammed Hankir; Stanislaus Reimer; Bernhard Petritsch; Christoph-Thomas Germer; Florian Seyfried Journal: World J Clin Cases Date: 2021-06-06 Impact factor: 1.337