Reconstruction Options After Resection of the Gastroesophageal Junction for a Refractory Stricture

Abstract

Resection for refractory peptic strictures at the gastroesophageal junction is often the option of last resort. While resection can be straightforward, the reconstruction options may vary depending on location of the stricture, surgeon experience, and other patient factors. We discuss 4 distinct reconstruction options, including gastric pull up to the upper chest or neck, roux-n-y esophagojejunostomy, colonic interposition, and jejunal interposition graft to the thoracic inlet or higher. Each has different considerations and potential complications. We recommend jejunostomy feeding tubes regardless of reconstruction planned.