Structurally, the esophagus is a muscular pipe lined with a mucous membrane that connects the pharynx and the stomach. Reconstruction of this structure is generally required after the removal of malignant tumors.
These tumors can be primary growths of the esophagus, or can involve the esophagus with a spreading from proximal areas. Radiation treatment of the area may also require partial or complete reconstruction of the esophagus. Partial reconstruction of the esophagus can be performed by transplanting a flap of the pectoralis major muscle with a section of attached skin. The muscle serves solely as a source of blood supply for the attached skin, and the skin section is sewn to the borders of the defect in the esophagus. Reconstruction of the pipe-like structure of the esophagus enables normal function, to a large extent.
Full reconstruction of the esophagus to create a complete pipe is performed by making use of free flap of skin that is sewn to create a tube, or by using a section of a small intestine. These are transferred with the blood vessels supplying them, and are connected to local blood vessels in order to renew the blood supply in the area of the defect.