Quagmire of esophageal replacement in infants and children

A normally functioning esophagus is a specialized functioning organ, and it functions in concert with other derivatives of foregut origin. Unlike adults, esophageal replacement (OR) in infants and children is uniformly done for benign conditions. The complexity of esophageal substitution techniques and its sequelae are not experienced only during childhood, but they spill over into adult life as well making life-long commitment and follow-up necessary. Although multiple technical approaches and their modifications are being practiced for OR over the past century, there is no clear consensus regarding the best one. In recent years, realizing that patient's own esophagus suits him/her best, esophageal lengthening and tissue engineering techniques are challenging the replacement techniques. There are no randomized controlled pediatric studies to compare different types of OR.