Long-term outcomes after colon interposition for esophageal replacement: a case series of four patients from a single centre

Abstract

Colon interposition remains a valuable option for esophageal replacement in complex pediatric and young adult cases. However, long-term functional and nutritional outcomes remain variable. We report the long-term outcomes of four patients (age at surgery: 2-11 years; current age: 3-23 years) who underwent transverse colon interposition at our centre for indications including long-gap esophageal atresia (n=2) and corrosive strictures (n=2). Median follow-up exceeded five years. Nutritional outcomes were variable: two patients achieved normal growth, while two demonstrated stunting and undernutrition. Laboratory profiles revealed borderline anaemia in one patient, with otherwise preserved micronutrient status. PedsQL™ assessments showed normal physical functioning in three of four patients, although psychosocial scores were reduced in three. Radiological and endoscopic evaluation identified anastomotic strictures in all patients, with associated reflux and tortuosity in three. Colon interposition can provide durable esophageal continuity with satisfactory long-term function. Nonetheless, complications such as stricture, reflux, and impaired growth are common, underscoring the need for structured, long-term multidisciplinary surveillance.