Adenocarcinoma of the Interposed Colon Graft for Esophageal Substitution-Point of View from a Tertiary Center in Esophageal Surgery and Review of Literature.

Abstract

Resection or bypass surgery for benign or malignant esophageal pathologies presents multiple challenges, which is why it is addressed to centers of digestiveexcellence. One such challenge is the restoration of the continuity of the digestive tract, the colon being an important option for esophageal substitution. Lon-term follow up of patients with colon reconstruction is essentially related to digestive-nutritional problems. An exceptional situation, by its particularity and evolution, is the appearance of pre-malignant lesions (polyps) or frankly malignant lesions of the colon graft. The aim of the article was to draw attention to the risk of such a long-term complication, unforeseen, difficult to manage diagnostically and therapeutically. At the same time, the limited data in the literature, usually case reports, leave a series of unanswered questions for the attending physician, both in terms of etiology and case management. That is why we wanted to review the literature, identify common elements with other authors, so as to seek working hypotheses and identify mechanisms or, at least, to signal such a possible complication.