Surgical approaches to esophageal cancer gastrointestinal reconstruction: a systematic review of jejunum, colon, and ileocolonic interposition with comparative outcome analysis

Esophageal cancer is a highly aggressive malignancy of the digestive tract, with surgical resection remaining the cornerstone of curative treatment. For patients with an intact stomach, reconstruction using a gastric conduit via gastric pull-up is the preferred approach following esophagectomy. However, in cases where the stomach is unavailable—due to prior gastric surgery, polyps, or concurrent tumors—alternative conduits must be considered. By reviewing relevant domestic and international research literature, this review evaluates the indications, benefits, limitations, and common complications associated with jejunal, colonic, and ileocolonic interpositions. Additionally, strategies for the prevention and management of complications are discussed. By synthesizing the latest clinical evidence, we aim to provide practical recommendations to guide surgical decision-making and improve outcomes in the management of esophageal cancer. The jejunum, colon, and ileocolon represent the primary options for esophageal reconstruction, each offering unique anatomical and functional advantages as well as distinct technical challenges and complication profiles.