Information from the abstract
Objective: We report a 10-year experience with supercharged colonic interposition (CI) for total oesophageal reconstruction, focusing on technical refinements and functional outcomes. Materials and Methods: A retrospective review of patients undergoing total oesophageal reconstruction (2014–2024) was conducted. A modified, supercharged CI was performed using a longer terminal ileal segment of 20–30 cm. Conduits were routed subcutaneously, and arterial supercharging—usually to the transverse cervical artery—was performed selectively. When congestion persisted, venous superdrainage was additionally implemented. Outcomes were compared with a contemporaneous gastric pull-up (GPU) cohort. Results: Twenty-one patients underwent reconstruction (11 CI, 10 GPU). No graft failures occurred after supercharged CI. Anastomotic leakage occurred in 18.2% of CI and 10.0% of GPU patients (P=1.00) and was managed without conduit loss. Stricture was more frequent after CI (36.4% vs. 10.0%, P=0.31) and was successfully treated endoscopically. At a median follow-up of 21 months, all CI patients tolerated oral intake (45.5% solid, 45.5% soft diet); feeding tube dependence was 27.3% after CI vs. 60.0% after GPU (P=0.19). Conclusions: Supercharged colonic interposition was associated with preserved graft viability and satisfactory functional recovery in patients requiring complex total oesophageal reconstruction. A defined selection algorithm, standardised technique, subcutaneous routing, and structured perioperative care offer a reproducible framework for complex oesophageal reconstruction when gastric pull-up is not feasible.
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Related topics: Esophageal and GI Pathology · Esophageal Cancer Research and Treatment · Reconstructive Surgery and Microvascular Techniques
Thai researcher and institutional participation
Sarut Chaisrisawadisuk · Pornchanit Karanthakarn · Sirin Apichonbancha · Nutcha Yodrabum · Jirawat Swangsri · Siriraj Hospital · Mahidol University
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