Nonsupercharged Retrosternal Roux-en-Y Esophagojejunostomy for Distal Esophageal Reconstruction

Area of Science:

• Surgical reconstruction
• Gastroenterology
• Esophageal surgery

Background:

• Distal esophageal reconstruction is necessary when the gastric conduit is unavailable.
• Nonsupercharged jejunum offers an alternative for esophageal reconstruction.
• Retrosternal Roux-en-Y esophagojejunostomy (RYEJ) is a technique for distal esophageal reconstruction.

Purpose of the Study:

• To describe a single-center experience with retrosternal Roux-en-Y esophagojejunostomy (RYEJ).
• To compare perioperative outcomes of RYEJ with retrosternal gastric pull-up (GP).

Main Methods:

• Retrospective chart review of patients undergoing retrosternal esophagostomy closure.
• Comparison of RYEJ group with a contemporary gastric pull-up (GP) cohort.
• Analysis of patient characteristics, complications, and outcomes.

Main Results:

• 9 patients underwent RYEJ, and 10 underwent GP.
• Previous esophageal adenocarcinoma was more common in the RYEJ group (P=.01).
• No significant differences in outcomes between RYEJ and GP groups were observed.

Conclusions:

• Retrosternal RYEJ is a safe alternative for esophagostomy closure when the stomach is unavailable.
• Nonsupercharged jejunum can be used for reconstruction in patients with adequate esophageal length.
• RYEJ offers comparable perioperative outcomes to gastric pull-up.