n South African Journal of Surgery - In total oesophageal reconstruction, try, try and try again : case report

Volume 47, Issue 4
  • ISSN : 0038-2361
  • E-ISSN: 2078-5151



Reconstruction of the oesophagus was not attempted until the late 19th century. Over the next 100 years, various reconstructive techniques proliferated, initially for malignant disease but subsequently for end-stage oesophageal failure from a variety of benign conditions. The earliest and simplest technique of applying a split-skin graft over a tubular stent was associated with poor graft survival and a risk of mortality from stent erosion into vital structures in the mediastinum. Management has evolved since then. The use of the pedicled colon has become a popular choice for the thoracic portion. Replacement of the cervical portion is commonly achieved by either free jejunal transfer or the free radial forearm flap. The literature is reviewed and a case report is presented in which three salvage options were exercised after partial failure of colonic transposition for total oesophageal reconstruction.

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