Skip to main content

Advertisement

SpringerLink
Log in

Successful 2nd reconstruction for failed ileocolonic interposition after esophagectomy

  • Case Report
  • Published:
Esophagus Aims and scope Submit manuscript

Abstract

We report a 53-year-old woman who underwent successful 2nd reconstruction following ileocolonic necrosis after esophagogastrectomy. The patient had the initial operation for simultaneous esophageal and gastric cancer with subtotal esophagectomy and total gastrectomy after retrosternal ileocolic reconstruction. Proximal ileocolonic necrosis developed on the 7th postoperative day and massive bleeding from the left carotid artery occurred 2 days later. She was referred to our hospital after recovery from the last operation for restoration of discontinued esophageal substitute. Partial sternal resection was followed by implantation of a free jejunal graft between the remnant colon and the cervical esophagus. The transferred jejunum was covered by a left latissimus dorsi musculocutaneous flap. Postoperative course was uneventful and she was discharged 29 days after operation. For extended necrosis of an esophageal substitute after retrosternal reconstruction for esophageal surgery, this surgical procedure seems to result in less surgical stress with physiological and cosmetic benefit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Wormuth JK, Heitmiller RF. Esophageal conduit necrosis. Thorac Surg Clin. 2006;16:11–22.

    Article  PubMed  Google Scholar 

  2. Briel JW, Tamhankar AP, Hagen JA, DeMeester SR, Johansson J, Choustoulakis E, Peters JH, Bremner CG, DeMeester TR. Prevalence and risk factors for ischemia, leak, and stricture of esophageal anastomosis: gastric pull-up versus colon interposition. J Am Coll Surg. 2004;198:536–41 (discussion 532–41).

    Google Scholar 

  3. Yamamoto Y, Minakawa H, Okushiba S, Motohara T. Surgical salvage of failed esophageal reconstruction attempted with gastric pedicle. J Reconstr Microsurg. 1997;13(4):285–9.

    Article  PubMed  CAS  Google Scholar 

  4. Fukuda C, Ide H, Sato Y, Noxaki M, Moriyama T, Naruyama K. A new device of jejunum interposition in a case of necrosed gastric tube after retrosternal gastric tube reconstruction. Nipoon Risho Geka Gakkai Zasshi. 2006;67:2388–91 (in Japanese).

    Google Scholar 

  5. Doki Y, Okada K, Miyata H, Yamasaki M, Fujiwara Y, Takiguchi S, Yasuda T, Hirao T, Nagano H, Monden M. Long-term and short-term evaluation of esophageal reconstruction using the colon or the jejunum in esophageal cancer patients after gastrectomy. Dis Esophagus. 2008;21:32–8.

    Article  Google Scholar 

  6. Renzulli P, Joeris A, Strobel O, Hilt A, Maurer CA, Uhl W, Büchler MW. Colon interposition for esophageal replacement: a single-center experience. Langenbecks Arch Surg. 2004;389(2):128–33.

    Article  PubMed  Google Scholar 

  7. Kawano T, Nishikage T, Kawada T, Nakajima Y, Kojima K, Nagai K. Subcutaneous reconstruction using ileocolon preserved ileocolic vessels following esophagectomy or in esophageal bypass operation. Dig Surg. 2009;26:200–4.

    Article  PubMed  Google Scholar 

  8. Anegg U, Lindenmann J, Maier A, Smolle J, Smolle-Jüttner FM. Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses. Br J Surg. 2008;95(3):344–9.

    Article  PubMed  CAS  Google Scholar 

  9. Coral RP, Constant-Neto M, Silva IS, Kalil AN, Boose R, Beduschi T, Gemelle TF. Comparative anatomical study of the anterior and posterior mediastinum as access routes after esophagectomy. Dis Esophagus. 2003;16(3):236–8.

    Article  PubMed  CAS  Google Scholar 

  10. Gawad KA, Hosch SB, Bumann D, Lübeck M, Moneke LC, Bloechle C, Knoefel WT, Busch C, Küchler T, Izbicki JR. How important is the route of reconstruction after esophagectomy: a prospective randomized study. Am J Gastroenterol. 1999;94(6):1490–6.

    Article  PubMed  CAS  Google Scholar 

  11. Kawai KI, Kakibuchi M, Sakagami M, Fujimoto J, Toyosaka A, Nakai K. Supercharged gastric tube pull-up procedure for total esophageal reconstruction. Ann Plast Surg. 2001;47(4):390–3.

    Article  PubMed  CAS  Google Scholar 

  12. Murakami M, Sugiyama A, Ikegami T, Aruga H, Matsushita K, Ishida K, Maruta F, Ikeno T, Shimizu F, Kawasaki S. Additional microvascular anastomosis in reconstruction after total esophagectomy for cervical esophageal carcinoma. Am J Surg. 1999;178(3):263–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8471, Japan

    Katsunori Nishikawa, Hideyuki Kashiwagi, Masami Yuda, Toshiyuki Sasaki, Yuichiro Tanishima, Noburo Omura, Yoshiro Ishibashi, Norio Mitsumori & Katsuhiko Yanaga

  2. Department of Plastic Surgery, The Jikei University School of Medicine, Tokyo, Japan

    Katsuhiro Ishida & Mitsuru Uchida

Authors
  1. Katsunori Nishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsuhiro Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mitsuru Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hideyuki Kashiwagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masami Yuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toshiyuki Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuichiro Tanishima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Noburo Omura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshiro Ishibashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Norio Mitsumori
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katsuhiko Yanaga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katsunori Nishikawa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nishikawa, K., Ishida, K., Uchida, M. et al. Successful 2nd reconstruction for failed ileocolonic interposition after esophagectomy. Esophagus 9, 180–183 (2012). https://doi.org/10.1007/s10388-012-0319-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10388-012-0319-7

Keywords

Search

Navigation