Technique of jejunal interposition for esophageal replacement

The use of jejunum as an esophageal substitute has not achieved the popularity that it would seem to deserve. As we have reported, it appears to have initial advantages in terms of adequacy of length, absence of graft failures, and relatively low initial complication rate. The advantages, moreover, increase with time- the continued active peristalsis and the absence of intrinsic diseases of the jejunum make it an attractive long-term substitute. These characteristics do not seem to be as consistently found in substitutions performed with either colon or stomach tubes. We describe the technique of jejunal interposition and analyze the objections to its use that have been raised.