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Posterior Cologastric Anastomosis: An Effective Antireflux Mechanism in Colonic Replacement of the Esophagus  Amr Abdelhamid AbouZeid, MD, Ahmed Medhat.

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Presentation on theme: "Posterior Cologastric Anastomosis: An Effective Antireflux Mechanism in Colonic Replacement of the Esophagus  Amr Abdelhamid AbouZeid, MD, Ahmed Medhat."— Presentation transcript:

1 Posterior Cologastric Anastomosis: An Effective Antireflux Mechanism in Colonic Replacement of the Esophagus  Amr Abdelhamid AbouZeid, MD, Ahmed Medhat Zaki, MD, Hesham Soliman Safoury, MD  The Annals of Thoracic Surgery  Volume 101, Issue 1, Pages (January 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Four-year-old boy underwent colon bypass for postcorrosive esophageal stricture. (A) The level of the distal end of the colonic flap is a fixed point distal to its pedicle. The level of the proximal end of the flap required to reach up to the esophagus in the neck is exactly measured using a tape as shown. (B) After exclusion of the required length of the colonic flap, the intestinal continuity is restored by a colocolic anastomosis. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Four-year-old boy underwent colon bypass for postcorrosive esophageal stricture. Combination of a posterior cologastric anastomosis with the retrosternal colon bypass was performed. (A) The greater curvature of the stomach is held upward, exposing the posterior surface of the stomach. (B) The cologastric anastomosis is completed on the back of the stomach. (C) The colonic conduit passes upward through the retrosternal tunnel and downward behind the stomach (St.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Postoperative gastrogram to check for the presence of gastrocolic reflux is performed in (A) a 7-month-old girl from the first group (anterior cologastric anastomosis), showing major gastrocolic reflux; and (B) a 21-month-old boy and (C) a 9-month-old girl from the second group (posterior cologastric anastomosis), showing no gastrocolic reflux. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Six-year-old boy (from the first group) presenting at follow-up with severe dyspeptic symptoms (hematemesis and loss of weight). (A, B) This patient was successfully managed operatively by transferring the cologastric anastomosis from the front to the back of the stomach (St). (C) Preoperative contrast study through the gastrostomy showed major gastrocolic reflux. (D) Postoperative gastrogram showing complete disappearance of the reflux. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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