The Supercharged Microvascular Jejunal Interposition

In a distinct subset of patients, traditional gastric conduits are not available as esophageal replacements, due to either intrinsic disease, tumor involvement, or previous surgery. Esophageal reconstruction in this group can prove daunting. Colonic interposition can be considered as an alternative conduit, but the "supercharged" jejunum (SPJ) may also serve as another option for total esophageal reconstruction. With an experienced hospital team familiar with esophageal surgery and microvascular reconstruction, morbidity is acceptable and long-term functional benefits may exist with this conduit. This article will review the indications and potential problems with the SPJ and will try to impart some of the important technical points that have been identified to minimize the risk of this complex but useful esophageal reconstruction.