Transhiatal oesophagectomy: A simple technique to carry out gastric or colonic conduit pull-up

Following transhiatal oesophagectomy, delivery of the conduit into the posterior mediastinum and neck can potentially result in its devascularisation. A simple technique is described to protect the conduit during this phase of the operation. This procedure has now been performed in 56 consecutive cases (54 gastric and two colonic conduits). In one case (1.8%) the colonic conduit had to be removed due to venous engorgement. The anastomotic leak rate was 8/56 (14%), and 12 (21%) patients required oesophageal dilatation for a stricture. There were no cases of ischaemia of the conduit. This technique provides a means of safe delivery of the oesophageal replacement into the neck following transhiatal oesophagectomy.