Selection and Placement of Conduits

Brian Mitzman, MD, Mark K. Ferguson, MD

Key Points

Many options exist for esophageal replacement depending on the clinical scenario, availability of gastrointestinal conduits, and technical ability of the surgeon. Gastric tubularization remains the mainstay for esophageal reconstruction due to excellent outcomes and technical ease when compared with other techniques. Long segment colonic interposition is an appropriate choice when the stomach is not available, but careful preoperative workup is necessary to ensure adequate blood supply. Ischemic necrosis of any conduit is a dreaded complication, and new techniques are being evaluated to help assess perfusion at the time of anastomosis.

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