Surgical management of colonic redundancy following esophageal replacement

Abstract

Colonic redundancy is the most common late complication following esophageal replacement by colonic interposition. Redundancy in the colonic graft leads to mechanical dysfunction of the neo-conduit, causing disabling symptoms that may develop decades after the original surgery. When symptoms caused by food retention in the colonic loop occur, surgical correction may be necessary to improve quality of life and to prevent complications such as aspiration if lifestyle modifications fail. We describe two cases where remedial surgery was performed for redundancy in interposed colonic grafts. Particularly attention is given to preoperative work-up and surgical technique. The literature is reviewed for the etiology, clinical features and management options of this condition. These cases illustrate a successful surgical technique for correcting this complication.