The Use of Colon for Œsophageal Replacement in Children

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Abstract
This article reviews the author's experience in replacing the œsophagus with a portion of colon in 31 children over a period of 14 years. When carried out for atresia or stricture, the procedure has in general been satisfactory, and modification of the technique over recent years has eliminated the majority of the complications that previously occurred. There were two deaths, one related to the operation and the other not. Experience suggests that the procedure is not satisfactory in the treatment of œsophageal varices.Summary: A review of our experience with œsophageal replacement employing a portion of the colon is presented. In 21 patients, there was one unrelated death and one death directly related to the operation.The majority of the complications have been related to the upper anastomosis in the neck. They have not developed in recent cases, where distension of the colon segment has been prevented by a tangential tubeless cervical caecostomy which in each instance has subsequently closed spontaneously.The use of a colon segment to replace the resophagus because of atresia or stricture has been most satisfactory and has been relatively free from long‐term complications.Failure to gain weight in three patients was found to be related to stricture at the neck anastomosis, which was not evident in a barium œsophagram. The diagnoses were made by œsophagoscopy, and the strictures were corrected surgically.Our limited experience, but with long‐term follow‐up, indicates that colon replacement of the œsophagus is an unsatisfactory method for the treatment of œsophageal varices.

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