title: Super-Charged Pedicled Jejunal Interposition Performance Compares Favorably With a Gastric Conduit After Esophagectomy.
abstract: BACKGROUND
  A variety of conduits can be utilized for esophageal reconstruction, but their postoperative function remains unknown. The objective of our study was to compare functional performance of super-charged pedicled jejunal (SPJ) to gastric conduits using a novel conduit assessment tool.
  
  
  METHODS
  Patients who underwent esophageal reconstruction between January 1, 2009 and December 31, 2013 were asked to complete questionnaires measuring postoperative functional outcomes. Conduit emptying and postoperative variables were recorded. Statistical analysis was performed using the Mann-Whitney U test and Fisher exact test for crosstabs.
  
  
  RESULTS
  Forty-five of the 94 esophageal reconstruction patients (48%) were alive, had either a gastric conduit or SPJ reconstruction, and completed the questionnaire. The mean age was 60.6 ± 12.5 years, 69% were male, and the majority of patients had cancer (87%). While the majority of the gastric patients underwent an oncologic resection for adenocarcinoma (65%), 50% of SPJ patients had undergone a previous resection (p = 0.008). The average time after surgery for last conduit assessment was 15 ± 13 months for the gastric conduit group and 17 ± 12 months for the SPJ group (p = 0.315). The average reflux, dumping, dysphagia, stricture, conduit emptying, and Zubrod scores were low and similar between groups: reflux 1.7 ± 1.9 for gastric conduit and 0.7 ± 1.3 for SPJ; dumping 0.97 ± 1.2 and 0.93 ± 1.1; dysphagia 0.60 ± 0.72 and 0.79 ± 0.89; stricture 0.7 ± 1.4 and 0.38 ± 0.96; conduit emptying 0.46 ± 0.93 and 0.33 ± 0.88; and Zubrod 0.84 ± 0.64 and 1.21 ± 0.8, respectively. The SPJ patients had a higher pain score (7.0 ± 3.2 vs 2.4 ± 2.4, p = 0.043).
  
  
  CONCLUSIONS
  Super-charged pedicled jejunal interposition performance is comparable with a gastric conduit after esophagectomy according to a novel, comprehensive conduit assessment tool.
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Stephens
authors.affiliation: The Methodist Hospital and Weill Cornell College of Medicine, Houston, Texas.
authors.forename: Puja
authors.initials: P
authors.lastname: Gaur
authors.affiliation: The Methodist Hospital and Weill Cornell College of Medicine, Houston, Texas.
authors.forename: Kathleen O
authors.initials: KO
authors.lastname: Hotze
authors.affiliation: The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
authors.forename: Arlene M
authors.initials: AM
authors.lastname: Correa
authors.affiliation: The Methodist Hospital and Weill Cornell College of Medicine, Houston, Texas; The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
authors.forename: Min P
authors.initials: MP
authors.lastname: Kim
authors.affiliation: Mayo Clinic, Rochester, Minnesota. Electronic address: blackmon.shanda@mayo.edu.
authors.forename: Shanda H
authors.initials: SH
authors.lastname: Blackmon
mesh_terms: D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures / Q000379:methods; D016629:Esophagectomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D020127:Recovery of Function; D013270:Stomach / Q000601:surgery*