[Adaptation of the esophagus, reconstructed using the colon, based on 135 cases of surgery in corrosive stenosis]

Abstract

Late aspects of adaptation were studied on the basis of 135 esophagoplasty by means of isoperistaltic (except of 7 anisoperistaltic) transverse colon for corrosive strictures. Histochemically, the augmentation of neutral mucopolysaccharide, which increases mucosal resistance--was observed on the surface and in Lieberkühn glands of colonic mucosa. Mucosal absorption remains unmodified. Transit time is considerable longer, but without functional consequences. Radiokinematographically, characteristic, coordinated, multihaustral, propulsive movements of transverse colon were present, playing a secondary, but active role in the swallowing mechanism. In the authors opinion, the marked differences between the iso- and anisoperistaltic interposition modality, in point of view of gastro-colic reflux, is explained by these unmodified, more independent, motor activity of the bowel wall. Good long-term functional results were present in 92% of patients. In management of corrosive strictures, isoperistaltic transverse colon may be considered the graft of choice, both technically and functionally.