Mohammed Shamim, Shahid Shamim.
Presternal Colon Interposition for Esophageal Strictures.
J Coll Physicians Surg Pak Jan ;12(6):341-4.

Objective: To establish the role of presternal interposition of colon for esophageal strictures, following corrosive ingestion. Design: An observational and prospective hospital-based study. Place and Duration of Study: Patients operated for esophageal strictures, following corrosive ingestion, at Abbasi Shaheed Hospital, Dr. Ziauddin Hospital and Social Security Hospital, Karachi, from 1987 to 2000, were included in the study. Materials and Methods: Five patients were operated for total or near total obliteration of full length of esophagus, during 1987 to 2000. Three of them were females, while 2 were males with a mean age of 21 (range 6-28 years). The cause of stricture was corrosive injury in all the patients. The strictured esophagus was bypassed surgically in all the patients by presternal interposition of ascending and transverse colon. Results: One patient died of aspiration pneumonia on the third postoperative day. Postoperative anastomotic leak in the neck appeared in 1 patient that responded to conservative management. One patient had minor leak from intra-abdominal anastomosis, which was drained. The functional result in all four living patients was good. A mean follow-up of five years was recorded in all of them. No late complication was seen during this period. Conclusion: Presternal interpositioning of colon is an acceptable option for patients with esophageal strictures. The technique is easy to learn and perform even with minimal operative facilities. Although the complication rate and morbidity associated with procedure was low in our study, a larger prospective study is required before commenting with certainty.

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