Colon interposition for wide gap oesophageal atresia.

ABSTRACT

A retrospective study covering December 1978 to December 1989 at Booth Hall Children's Hospital, Manchester, revealed that 12 colon interposition were performed in 11 children to reconstruct their oesophagus. All were for wide-gap oesophageal atresia with or without fistula. One patient underwent colon interposition twice due to ischaemia of the initial transplant. Waterston's transthoracic procedure was used mostly with a modification by Freeman performed in one patient. Main early postoperative complications included proximal anastomosis leak (45.5%) and respiratory infection (36.4%). Late complications were proximal anastomotic stricture (22.2%); gastrointestinal problems (66.7%); and recurrent respiratory infection (11.1%). Although colon redundancy radiologically was noted in two patients, they were well with no dysphagia. Mortality was 18.2%, the two patients dying suddenly two weeks after colon transplant from pulmonary complications. At follow-up (mean 6.2 years) growth rate had improved slightly, and 11.1% weighed above the 10th percentile. However, 77.8% could swallow satisfactorily within one year of surgery.