Right colon interposition in benign esophageal stricture and gastric atrophy: technical nuances and functional...

We present the case of a 43-year-old woman with complete esophageal and gastric stenosis after caustic ingestion. Following initial emergency surgery for gastric perforation, she remained dependent on a jejunostomy for over a year, developing severe malnutrition, dysphagia, and psychological decline. Definitive reconstruction was achieved with a one-stage subtotal esophagectomy and total gastrectomy. A right colon interposition graft, routed through the posterior mediastinum, was used after confirming adequate perfusion despite the absence of the right colic artery. The procedure included a cervical esophago-colonic anastomosis, Roux-en-Y colojejunal anastomosis, ileotransverse bypass, and incidental cholecystectomy and appendectomy. Postoperative recovery was uneventful, with the patient resuming soft oral intake, gaining weight, and showing marked nutritional and functional improvement. This case underscores the value of right colon interposition when the stomach is unavailable, highlighting the need for tailored conduit choice, precise vascular assessment, and multidisciplinary perioperative care in complex benign esophageal disease.