ABSTRACT
Gastric transposition has the advantage of involving only one well-vascularized anastomosis that is associated with a low incidence of leakage. Notably, gastric transposition is presently the procedure of choice for esophageal replacement in adults with esophageal carcinoma. The importance of sham feeds in infants with long-gap esophageal atresia who have undergone a cervical esophagostomy in simplifying the initiation of oral nutrition following the interposition should not be underestimated. Temporary jejunostomy should always be considered in any case of poor feeding abilities. The initial feeding gastrostomy should ideally have been sited on the anterior surface of the body of the stomach, well away from the greater curvature, in order to preserve the vascular arcades of the gastroepiploic vessels. A large artery forceps is passed through the posterior mediastinal tunnel from the cervical incision to appear via the esophageal hiatus into the upper abdomen. The neck wound is closed in layers.
