Clinical Utility of Three-dimensional Computed Tomography for Esophageal Reconstruction using Colon Interposition after Gastrectomy

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Reconstruction after esophagectomy may represent a serious problem when a previous gastric resection has been performed. The colon is frequently used, but the marginal artery is of insufficient caliber to maintain the viability of a transposed colon. Three-dimensional computed tomography (3D-CT) provides abundant information about a patient's anatomy without requiring an arterial puncture. We present a case in which 3D-CT was used. A 68-year-old man who had previously undergone a gastrectomy was diagnosed with esophageal cancer. 3D-CT showed that the left colic artery was straight and long and had a solitary branch from the inferior mesenteric artery. The vascular pedicle of the left colon was found during the operation to be in accord with the 3D-CT evaluation. The patient underwent a transthoracic esophagectomy, followed by reconstruction using left colon interposition. No anastomotic leakage or necrosis of the reconstructive colon occurred.