Gangrene in esophageal substitutes after resection and bypass procedures for carcinoma of the esophagus.

In 760 resection and bypass procedures for esophageal cancer, 30 patients (3.9%) developed gangrene in the esophageal substitute. The incidence in resection cases was similar to those who were bypassed. The important factors in its development were the length and type of organ used as an esophageal substitute. Gangrene was almost exclusively seen when the upper anastomosis was in the neck; the lowest incidence occurred when stomach was used (1%), while the highest was seen with jejunum (11.3%) and colon (13.3%).