Vascularized Jejunal Tube

The definition of long gap esophageal atresia in the past has always been controversial. In a recent position paper on long gap esophageal atresia, the definition was clearly determined as those types of atresia that had no air on plain abdominal X-rays, that is, type A and B. Jejunal interposition is ideally suited for esophageal replacement if (delayed) primary anastomosis or traction technique is not possible or has failed. Although the technique needs meticulous dissection, in the follow-up, there remains good isoperistalsis, and the jejunum has a similar growth rate to that of the normal esophagus. There is little or no reflux and pulmonary symptoms are infrequent. This chapter describes the surgical steps of jejunal interposition and follow-up. In comparison to other techniques, the jejunal interposition has a favorable outcome in the long run.