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June 14, 1958


Author Affiliations


From the Department of Surgery, Jefferson Medical College of Philadelphia. Dr. Amadeo is a Fellow of the American Cancer Society.

JAMA. 1958;167(7):832-835. doi:10.1001/jama.1958.02990240032006

Reestablishment of continuity of the passage from pharynx to stomach after removal of a diseased esophagus, or in the absence of the esophagus, formerly depended on the use of external tubes constructed of skin, stomach, or small intestine. These have been unsatisfactory for various reasons. Since 1951 it has been possible to reestablish the connection of pharynx to stomach by a retrosternal segment of colon within the thorax. Three cases are described illustrating the usefulness of this procedure in three types of esophageal disease. In one patient, a 64-year-old man, carcinoma had infiltrated most of the esophagus, and a previously unsuspected fungating carcinoma was found in the stomach at operation. The substitution of a segment of colon for the esophagus was successfully carried out, and the transplanted colon functioned well for six months until death. Substitution of colon for esophagus likewise succeeded in an 11-year-old girl with esophageal stricture after the ingestion of lye, and in a 3-year-old boy born with complete atresia of the esophagus. In both children subsequent growth has been normal. This type of operation is recommended particularly for benign lesions of the esophagus in which long-term survival is anticipated.