Abstract
When loss of anti-reflux function between the esophagus and the stomach occurs from destruction of the distal esophagus by ulceration, fibrosis or perforation, the ability to construct a competent valve surgically (Nissen, Hill or Belsey), is lost. In these cases, interposition reproduces a structure that prevents reflux acid burn of the distal esophagus. Human colon and jejunal segments are available. In my opinion, based on the literature and my own experience, the jejunal loop will offer a uniquely better resistance to esophageal acidity if properly interposed between the esophagus and the stomach. The basis for this rests on anatomic, radiographic and physiologic phenomena.
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References
Merendino KA, Dillard DH (1955) The concept of sphincter substitution by an interposed jejunal segment for anatomic physiologic abnormalities at the esophagogastric junction. Ann Surg 142:486
Moylan JP, Bell JW, Cantrell JR, Merendino KA (1971) The jejunal interposition operation: A follow-up on seventeen patients followed 10 to 17 Years. Ann Surg 172:205
Polk HC (1980) Jejunal interposition for reflux esophagitis and esophageal stricture unresponsive to valvuloplasty. World J Surg 4:731–736
Burrows L, Frankel A (oral permission)
Jones EL, Skinner DB, DeMeester TR, Elkins RC, Zuidema GD (1973) Response of the interposed human colonic segment to an acid challenge. Ann Surg 177:75
Wilkins EW Jr (1980) Long-segment colon substitution for the esophagus. Ann Surg, Vol 192, #6, pp 722–24
Belsey R (1965) Reconstruction of esophagus with left colon. J Thorac Cardiovasc Surg 49:33
References
Sirak HD, Clatworthy HW, Elliot DW (1954) An evaluation of jejunal and colic transplants in experimental esophagitis. Surgery 36:399–410
Dillard DH, Merendino KA (1956) New studies in the dog supporting the concept of equal resistance of various levels of the intestinal tract to acid peptic digestion. J Surg Gynec Obstet 103:289
Ferrer JM, Bruck HM (1969) Jejunal and colonic interposition for non-malignant disease of the oesophagus. Ann Surg 169:533–543
Pasch AR, Putnam T (1985) Jejunal interposition for recurrent gastro-oesophageal reflux in children. Am J Surg 150:246–251
Mignon M, De Mestier Ph, Zielinski B (1984) The problem of remaining gastric acidity. In Cancer of the Esophagus in 1984. OESO international Congress. Maloine Publ p 280–281
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© 1989 Springer-Verlag Berlin Heidelberg
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Sicular, A., Mignon, M., Ratineau, F. (1989). Can a jejunal loop offer more resistance to acidity?. In: Giuli, R., McCallum, R.W. (eds) Benign Lesions of the Esophagus and Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73055-9_134
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DOI: https://doi.org/10.1007/978-3-642-73055-9_134
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