Physiological implications of gastric transplantation for reconstruction of the cervical esophagus

Transplantation of segments of stomach has been proposed and used as a clinical technique for reconstruction of the cervical esophagus. Review of reports of these operations reveals that the gastric antrum is most frequently used for flap tissue. Based on knowledge of the functions of the gastric antrum, prediction of complications of gastrin physiology and gastric emptying could be anticipated after transplantation of the antrum from its normal anatomical site. Although clinical complications suggestive of antral dysfunction are included in reports of clinical gastric transplantation, none of the investigators or practitioners of this procedure have comprehensively investigated the physiological consequences of gastric transplantation. This procedure raises a number of complex physiological issues that should be thoroughly examined experimentally before this operation can be safely used clinically.