Ten patients have been presented in whom esophageal replacement with a reversed gastric tube has been accomplished. This operation provides a physiological means of esophageal replacement and offers the following advantages:
1. The reversed gastric tube looks and functions like a normal esophagus.
2. All foods can be swallowed in a normal manner.
3. The entire esophagus can be replaced.
4. Eighty per cent of the stomach remains in the abdomen retaining the normal storage function.
5. Peptic esophagitis does not occur because the antrum, which does not secrete acid, forms the portion of the reversed gastric tube which is anastomosed to the esophagus.
6. There is no intestinal organ or foreign material interposed between the proximal esophagus and the stomach.
7. The blood supply to the reversed gastric tube is excellent.
8. The reversed gastric tube is brought to the neck through a subcutaneous tunnel. If the esophageal obstruction is caused by a benign stricture or an inoperable carcinoma, thoracotomy need not be performed.