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Colonic interposition grafts

Colonic interposition has largely been superseded as an oesophageal replacement technique. (177–182) However, there remain adults born with long-gap OA with these grafts who are becoming increasingly troubled by complications from the graft. Burges et al. (183) found 27% of these patients had needed further procedures since repair. This is anticipated to increase as this patient cohort ages and the graft ages with them. There are a number of complications specific to colonic interpositions discussed below; however, many present with similar symptoms. Management of this complex patient group is best performed by tertiary care, though this varies in speciality from thoracic surgeons to upper gastrointestinal surgeons depending on who has a specialist interest in the condition in the region or country. The TOFS charity has a list of those known to have such experience in the UK.


Each patient’s anatomy and symptoms are unique, but many of the complications with colonic interpositions present with similar symptoms.

  • Severe and worsening dysphagia
  • Worsening regurgitation
  • Recurrent aspiration pneumonia
  • Retrosternal and/or abdominal pain
  • Weight loss
  • Worsening cough
  • Halitosis
  • Dyspepsia
  • Postprandial neck and chest swelling and oedema is only reported in graft redundancy