2017 年 30 巻 3 号 p. 161-166
To reconstruct esophageal defects, free jejunum or pedicled colon is commonly used if the stomach cannot be lifted to the neck.
In the past 6 years, supercharged pedicled colon was indicated in 4 male patients aged 61 to 70 years old ( mean 66.3 y/o ) after total esophagectomy with or without gastrectomy. The colon is preferably harvested transverse to the left side instead of the right because it has a longer arc, less vascular variation and dilatation, and may orthodromically replace a defect. All cases were successful without major complications after approximately 50 months of follow-up, except in 1 patient who died due to a tumor 18 months after surgery.
A monitor flap was not set in the surgical site, but the vasculature of the grafted intestine was checked with an echo Doppler probe immediately after the surgery and until 5 days after the surgery. Water testing was done on the 5th operative day and swallowing of liquid food was started after another 5 days. Food stagnation occurred temporally in one case, but improved in a few weeks.
This procedure was demonstrated to be less stressful and reliable from a small series experienced by our team.