Microvascular "supercharged" cervical colon: Minimizing ischemia in esophageal reconstruction

Traditional colonic reconstruction of the esophagus is performed by cervica l transposition of an isolated segment of colon with the vascular supply de rived from one of the mesenteric colic vessels. The transposed cervical por tion of the colon is farthest from the vascular supply and is at risk of is chemic injury. Despite notable risk of ischemic complications to the coloni c neoesophagus, reports advocating a "supercharged" microvascular augmentat ion of the vascular supply to the cervical portion of the colon remain few in number. Herein, the ischemic complications associated with traditional t ransposition of the colon for esophageal reconstruction are reviewed, and a voidance by microvascular "supercharging" of the cervical colon is advocate d under particular circumstances. The authors present a case of colonic int erposition for esophageal replacement requiring a cervical microvascular an astomosis for survival of the transferred colon.