Abstract
A gastric conduit is the first choice for esophageal reconstruction because of its robust blood supply and the need for only a single anastomosis to re-establish continuity with good results. In cases where the stomach is unavailable, a colon conduit is preferentially selected as an esophageal substitute. However, a colon reconstruction is more highly nvasive compared with a gastric conduit reconstruction. alvage esophagectomy after definitive chemoradiotherapy s associated with high morbidity and mortality rates. Gasric conduit necrosis is one of the most critical complicaions after salvage esophagectomy, potentially leading to n-hospital death. Gastric conduit necrosis can occur when he upper part of the stomach is included in the radiation rea of definitive radiotherapy; a damaged stomach with dematous changes and/or redness should be resected (Fig. ). In such cases, we have previously performed free-jejunal raft interposition or used a colon conduit to avoid anasomosis of the damaged stomach to the cervical esophagus. ere, we present our experience with duodenal transecion, which preserves the right gastroepiploic vessels, enbling safe anastomosis at the lower level of the gastric onduit, where the effect of definitive radiation therapy is bsent. Given the non-necessity for microvascular anastoosis, this method might represent a suitable minimally nvasive technique that minimizes organ sacrifice in this urgical setting.
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