Several types of gastrointestinal autografts have been used to replace the esophagus after extirpation of carcinomas. Successful reconstructions have been achieved most frequently with:

A. Stomach.

DISCUSSION: Although all of the listed bowel segments have been used successfully for reconstruction of the esophagus following removal of carcinomas, the stomach remains the most frequently used autograft for esophageal reconstruction. Because of its excellent blood supply the procedure can be performed at little risk as a single operation and achieve satisfactory long-term relief of dysphasia in at least 90% of patients. Either the entire stomach can be drawn into the chest or a gastric tube created in an isoperistaltic or antiperistaltic manner of sufficient length to reconstruct the entire esophagus. The advantages of a mucosal lining, serosal covering, natural opening into the stomach, and excellent blood supply based on the gastroepiploic vessels make the stomach the autograft of choice in most situations.