A new technique for esophagoplasty in relatively long esophageal strictures
The recent surgical treatment of two patients with relatively complex esophageal problems is described. In one patient, a long segment of proximal intrathoracic esophagus was mobilized during the course of surgery, and it was noted that the esophagus was viable and had a good blood supply at the distal margin of resection. In the other, the entire cervical and intrathoracic esophagus remained viable after mobilization. The obvious viability of these long esophageal segments detached from the segmental blood supply prompted us to preserve and use them in reconstruction. These observations suggest that there is a rich intramural arterial and venous network complementing the segmental blood supply of the esophagus. Although previous studies have clearly demonstrated a rich intramural esophageal vasculature, to the best of our knowledge it had not been clearly demonstrated that such lengths of esophagus could be mobilized from their segmental blood supply and remain viable. The details of these two cases are presented and discussed to document this observation and the manner in which it was possible to modify the esophageal reconstruction favorably by the use of the mobilized segment of esophagus.