Colon interposition

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As Koloninterposition which is operative interposition of a colon section ( colon ) in the surgery referred. The section of intestine used is then the colon interposal .

indication

Colon interposition is used to bridge the gap after the removal of another organ segment in the digestive tract . It is mainly performed after the esophagus ( esophagectomy ) or the stomach ( gastrectomy ) have been removed .

Action

A sufficiently long section of the colon is selected, closed orally and aborally in the appropriate length and cut. Then the section is “mobilized”, i. H. Detached from all adhesions to the large mesh , to the omental bursa and to the retroperitoneum , whereby the utmost care must be taken to preserve the arteries and veins that supply it. It is then connected orally and aborally to the remaining ends of the removed stomach or esophagus ( anastomosed ). Since the 1980s, this has increasingly been done using mechanical stapling devices.

The two closed ends of the colon are then also joined together by means of an anastomosis .

All sections of the colon can be used for colon interposition. However, the transverse colon (transverse colon) and the upper part of the descending colon (descending colon) are preferred . The reason for this is the vascular supply to these colon sections, which can be mobilized much better than that of the other sections.

Due to the critical blood supply, colon interposition is now the method of second choice, both in gastrectomy , in which the small intestine is used to re-establish the passage, and in esophagectomy , in which the gastric pull-up is the better option. In addition, 3 instead of 2 anastomoses are required for colon interposition, so that there is also a slightly higher risk of anastomotic leakage .

swell

  • Gerlind Souza-Offtermatt u. a .: Intensive surgery course . Elsevier, Urban & Fischer Verlag, Munich 2004, p. 295, ISBN 3-437-43490-X .
  • Sieglinde Bogensberger (Ed.): Roche Lexicon Medicine . 4th edition Urban & Schwarzenberg Verlag, Munich 1998, ISBN 3-541-17114-6 (on behalf of Hoffmann-La Roche AG).