[Gastroesophageal reflux after reconstruction of the esophagus with colon interposition]. / Refluks zoladkowo-przelykowy po zabiegach wytwórczych przelyku z jelita grubego.

In this study 113 cases were analysed; in which colon interposition was used for the reconstruction od the esophagus. The function od the esophageal grafts was evaluated 2 to 36 years after the reconstruction. Massive reflux was observed mainly when the anastomosis had been made to the gastric fundus. Reflux to isoperistaltic grafts was found in 21% of cases in children and in 27% od cases in adults, whereas for antiperistaltic grafts is was found in 33% od cases in children and in 61% od cases in adults. 4 children and 7 adult patients required a a reoperation.

[Surgical methods of protecting grafts from the colon against gastric reflux]. / Chirurgiczne sposoby zabezpieczenia przeszczepu z jelita grubego przed refluksem tresci zoladkowej.

The authors presented their methods of protecting esophageal grafts made of colon intestine from the gastric reflux to the graft; the methods were invented in their Department and verified in clinical practice. 51 patients had anti-reflux interpositions of jejunal or ileo-cecal segments made during the initial reconstruction or as a reoperation. Despite this, reflux was found on control examination in 12 cases, 8 of which had esophagitis confirmed by histology.

[Experimental studies for working out a new method of anastomosing esophageal grafts using large intestine to the stomach (after burn injury or partial resection (after burn injury or partial resection)]. / Badania eksperymentalne nad opracowaniem sposobu zespolenia przeszczepu z jelita grubego z zoladkiem (po oparzeniu lub czesciowej resekcji).

New methods of anastomosing the stomach to esophageal grafts made of the large intestine after burn injury or partial resection, with simultaneous reconstruction of the valve apparatus, were studied experimentally on pigs. The first method consisted in the transposition of a mucosal cuff from the end part od the graft to a submucosal tunnel on the front wall of the stomach. The other method consisted in construction of a valve using only the mobilized mucosa of the graft.

Operative procedure in early carcinoma of the thoracic part of the esophagus.

The authors present four patients with early carcinoma of the thoracic part of the esophagus. In all patients, "blind" esophagectomy was performed without thoractomy. Simultaneously salivary fistula on the neck and gastrostomy was formed. During the second stage of the procedure a retrosternal esophagus was formed out of pedunculated intestinal grafts. No serious postoperative complications were noted. According to the authors, the above-mentioned procedure should be limited to early cases of carcinoma of the thoracic part of the esophagus. The post-operative follow up of the cases was up to four years.

Surgical reconstruction of the oesophagus.

Reconstructive oesophageal surgery underwent 322 patients in our clinic. The surgery was indicated because of cicatrical obstructions or cancer of the thoracic part of the oesophagus. The continuity of the alimentary tract was re-established by pedunculated intestinal segment from the jejunum, ileum or left side of the colon in the anisoperistaltic position. The right side of colon was used either in iso- or anisoperistaltic position. The follow-up after completion of the reconstructive operation ranges from 1-40 years.

[Colon or ileum for reconstruction of the total esophagus with reference to vascularization]. / Kolon oder Ileum für die Rekonstruktion des gesamten Osophagus je nach dem Gefässverlauf.

Depending on the type of vascularisation of the transplant the authors present 7 different methods of using the most suited transplant (ileum, right and left sited colon in iso- and anisoperistaltic position) for reconstructing oesophagus. The authors performed 220 operations of this kind.