TY - CHAP M1 - Book, Section TI - Options for Esophageal Replacement A1 - Hofstetter, Wayne A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - Reestablishing gastrointestinal continuity after esophagectomy can be challenging for both the patient and the surgeon. There are no perfect substitutes because every reconstructive alternative is inferior to the native, normal esophagus. Ultimately, the goals for reconstruction include the maintenance of continuity, ability to swallow followed by adequate transit of food through the replacement conduit, provision of some barrier to reflux and aspiration, and independence from nutritional sources other than a normal oral diet. Simultaneously, every surgeon has the obligation to minimize morbidity, mortality, and long-term alterations in quality of life to the greatest extent possible. At odds to these objectives are the indications for removing the native organ and the extent to which it must be sacrificed. Clearly, situations that require complete removal of the esophagus up to the base of the tongue necessitate different reconstructive efforts compared to junctional tumors where a portion of the thoracic esophagus can remain intact. Esophageal surgeons must be adept and versatile at many different replacement options. This chapter focuses on the description of reconstructive options, emphasizing conduits other than stomach as described in previous chapters (Fig. 23-1). Where possible, an attempt is made to compare our experiences with the other conduit options, with the caveat that there are no level 1 data pertaining to such comparison. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170406692 ER -