esophagojejunal

Esophagojejunal describes a surgical connection between the esophagus and the jejunum, most often in the context of reconstructive esophageal surgery. It is typically performed after esophagectomy when a jejunal interposition conduit is used to replace the resected esophagus, or when the stomach cannot be used to form a gastric conduit. The resulting esophagojejunal anastomosis joins the proximal esophagus to a segment of jejunum that has been prepared and brought into the appropriate position for continuity.

Technique and approaches vary. The jejunal segment is isolated with preserved blood supply, brought up through the chest or neck, and connected to the remaining esophagus. The anastomosis can be fashioned end-to-end, end-to-side, or with stapling devices, and is usually performed under tension-free conditions to promote healing. Route selection (cervical versus intrathoracic) depends on the chosen reconstruction plan and tumor location, as well as surgeon preference and patient factors. Adjunctive measures such as pyloric drainage and early enteral feeding are sometimes used to support recovery.

Complications are similar to other esophageal anastomoses and include anastomotic leakage, stricture, conduit ischemia or obstruction, and postoperative infection. Other risks include reflux or aspiration, anastomotic ulcers, and functional dysphagia. Outcomes depend on disease stage, patient comorbidity, surgical technique, and perioperative care. Esophagojejunal reconstruction remains an important option when gastric conduit reconstruction is not feasible or when a jejunal interposition is preferred for functional reasons.