Colon Graft Necrosis during Colon Interposition for Esophageal Reconstruction Following Esophagectomy

Since the first use of the colon for esophageal reconstruction by Kelling and Vulliet, the colon reconstruction became a reliable surgical option to reconstruct partially or totally the diseased esophagus. Over the time, the efficacy of colon graft has been thoroughly evaluated and definitively attested by competent surgeons. However the selection of colon segment and completion of the esophageal anastomosis constitute the greatest challenge during esophageal reconstruction. Furthermore the selection of an optimal colon graft should be based on the adequacy of blood supply and the length of reconstruction. The viability and function of the graft affect greatly surgical outcome and functional results. Therefore, knowledge of risk factors, diagnosis, management, and prevention of colon graft necrosis is key to understand and to perform successfully an esophageal reconstructive surgery.