Health Library

Colonic Interposition

Conditions Requiring Colonic Interposition

Colonic interposition is a surgical procedure, mostly performed on infants and children following an esophagectomy (removal of part of the esophagus).

Your child may require colonic interposition due to:

• Caustic ingestion: accidental or intentional ingestion of a toxic or corrosive substance
• Congenital anomalies: including esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), where the esophagus is not formed correctly at birth

How Does the Colonic Interposition Procedure Work?

The surgery involves removing a piece of colon. This living tissue is called the colon graft. The graft is used to reconnect the remaining esophagus and stomach. The length of piece of colon is based on your child’s specific situation.

The video below shows 3D animation of the colonic interposition procedure.

Possible Risks and Complications of Surgery

As with any surgical procedure, there may be complications. Potential risks include:

• Trouble swallowing
• Weight loss
• Gastrointestinal reflux
• Pneumonia
• Narrowing of the esophagus

Some complications may require additional treatment and / or surgery.

Recovery Overview

Your child’s surgeon will provide specific instructions during your child’s recovery period.

Initial recovery from colonic interposition lasts about two months, including a hospital stay of 10 to 21 days. Typically, your child will receive intravenous (IV) nutrition for the first five to seven days after the operation. Your child may then be allowed to have liquids by mouth or tube feedings may be started. Your child should also use a pillow to raise the head while sleeping. This will prevent stomach acid from moving upward into the esophagus.

Within the first weeks after surgery, your child may have some trouble swallowing, feel full more quickly, and may have episodes of diarrhea and fatigue. These side effects lessen over time as your child’s body adapts.

The doctor will continue to monitor your child’s condition and progress. This monitoring includes office visits and endoscopies in the operating room. Long-term follow-up may be needed to follow your child's progress through various stages of their life.