ArticleJTCVS techniques2026
Nonsupercharged cervical Roux-en-Y esophagojejunostomy for esophageal reconstruction.
Article in JTCVS techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To explore whether the use of nonsupercharged jejunum as a substitute for esophagus is feasible among select patients involved in esophageal reconstruction. Methods: Twenty-two cases of nonsupercharged cervical Roux-en-Y esophagojejunostomy from January 2021 to April 2025 by 1 medical team in our center were analyzed. We typically preserved the first jejunal arterial branch and divided the second and third jejunal branches. Roux-en-Y esophagojejunostomy was performed without cervical microvascular anastomosis. Patient demographic data, perioperative characteristics, quality of life at 6 months postoperatively and survival outcome were recorded. Results: Of the 22 cases reported, 19 patients were men with median age of 69 years (range, 53-80 years). The most common cause of the use of jejunal conduit was unavailability of gastric conduit (n = 18 [81.8%]) due to prior gastrectomy followed by the necrosis of colonic graft (n = 2 [9.1%]) and gastric conduit (n = 2 [9.1%]). The median operation time was 270 minutes (range, 150-491 minutes). The median duration of postoperative hospital stay was 11 days (range, 5-42 days) with 5 days (range, 1-37 days) in the intensive care unit. There were 4 (18.2%) cases of anastomotic leakage. None of the patients experienced necrosis of the jejunal afferent loop. All patients, except for 1, reported good oral feeding postsurgery. One patient died within 3 months after surgery due to anastomotic leakage and iatrogenic jejunal conduit perforation. The patient-reported quality of life outcome showed high scores in global health status and low scores in symptom. The postoperative 1- and 2-year overall survival rate was 0.802 (95% CI, 0.624-1.000) and 0.501 (95% CI, 0.277-0.907), respectively. Conclusions: A cervical Roux-en-Y esophagojejunostomy without cervical microvascular anastomosis is a safe and feasible approach among select patients, especially for those who have undergone upper gastrointestinal tract reconstruction, such as Roux-en-Y, Billroth I reconstruction, Billroth II reconstruction, or jejunostomy.
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