Key Points

• Many options exist for esophageal replacement depending on the clinical scenario, availability of gastrointestinal conduits, and technical ability of the surgeon.
• Gastric tubularization remains the mainstay for esophageal reconstruction due to excellent outcomes and technical ease when compared with other techniques.
• Long segment colonic interposition is an appropriate choice when the stomach is not available, but careful preoperative workup is necessary to ensure adequate blood supply.
• Ischemic necrosis of any conduit is a dreaded complication, and new techniques are being evaluated to help assess perfusion at the time of anastomosis.