ABSTRACT
Colon interposition grafts are rarely used for esophageal replacement as the use of the gastric conduit is technically easier and usually available. When colons are used, endoscopic surveillance should be performed for esophageal cancer recurrence as well as primary colon cancer appearance. Here, we present a case report of a 58-year-old male with long segment high-grade Barrett’s dysplasia who underwent transhiatal esophagectomy, complicated by anastomotic breakdown with mediastinitis. He required cervical esophagostomy and takedown of gastric conduit, with eventual reconstruction and restoration of alimentary continuity with a substernal colon interposition conduit. On surveillance endoscopy, a polyp at the esophagocolonic anastomosis was found to be invasive colonic adenocarcinoma 12 years after colon interposition reconstruction. A partial colectomy via partial sternal split with a new esophagocolonic anastomosis was performed for pathologic stage I colon adenocarcinoma.
