ABSTRACT
The colon was routinely used to bypass the esophagus for palliation, but the advent of self-expanding metal stents means that this is rarely performed nowadays. Quality of life after esophagectomy is of paramount importance and is often overlooked, especially in the setting of malignant disease. Patients enjoy eating and want to do it without symptoms of fullness, pain, reflux, regurgitation, or aspiration. Therefore, the conduit must function well and have the capability of propelling food from the pharynx to the stomach. Severe intrinsic disease of the colon will preclude its use. Absolute contraindications include colorectal malignancy, polyposis coli, inflammatory bowel disease, severe diverticular disease, and inadequate blood supply due to atherosclerotic disease. Colonic interposition requires meticulous surgical technique and is demanding on both the patient and surgeon. Increased incidence of duodenogastric reflux is common when transposing the stomach into the thoracic cavity.
