Bruce Jaffray

If we were anastomosing esophaguuses with excess tension and the repairs were failing, you would expect us to have a very high incidence of oesophageal replacement, and we don't. So most of these cases, the vast majority are anastomosed without problems.

Most often they can, if you mobilize both ends sufficiently. The esophagus has got a great intrinsic blood supply, and you can easily mobilize it right down to the diaphragm and right up to the thoracic inlet, and it will stay alive.

So I think Unless you, you know, have an experienced surgeon who says after maximum mobilization, I genuinely can't get this together. I can't see that esophageal lengthening is required.

If esophaguses were being anastomosed with excess tension and repairs were failing, there would be a very high incidence of esophageal replacement, which is not seen in the Newcastle series.

The esophagus has a great intrinsic blood supply and can be mobilized right down to the diaphragm and right up to the thoracic inlet and will stay alive.

Unless an experienced surgeon says after maximum mobilization they genuinely can't get the esophagus together, esophageal lengthening is not required.