General Considerations

• Both the stomach and colon can be used as a substitute for the esophagus
• The indication for the procedure is usually malignancy of the esophagus; benign conditions include esophageal atresia and strictures from caustic esophagitis
• The stomach is more frequently used than the colon today
• When the colon is used, it is aligned so that peristalsis proceeds in the normal caudal direction
• The left colon is usually used because of its vascular supply
• Complications include ischemia, anastomotic leak and strictures



The colon, outlined by swallowed barium, is seen interposed between the proximal esophagus and the stomach.

Colon Interposition for Esophageal Replacement: An Alternative Technique Based on the Use of the Right Colon. Heinrich Fürst, MD, Wolfgang Hugo Hartl, MD, Florian Löhe, MD, and Friedrich Wilhelm Schildberg, MD. Ann Surg. 2000 Feb; 231(2): 173–178. 

Colonic Interposition. Farooq Agha and Mark Orringer. AJR. 142, April, 1984.