Timing and protocols of endoscopic follow-up in operated patients after esophageal surgery

After esophagectomy, the surgical defect is reconstructed to form an esophageal conduit to maintain the continuity of digestive tract. The reconstruction requires the transposition of stomach (gastric pull-up), intestinal graft, or musculocutaneous graft to replace the esophagus. Despite continuous refinements over decades, this technique is still associated with high risk of graft-related complications such as necrosis, leakage, fistula, strictures, or impaction. Local recurrence of primary esophageal cancer and development of metachronous cancers in the remnant esophagus are constant risks for neoplastic patients undergoing esophagectomy. Failure to detect these complications during follow-up may lead to severe or even fatal outcomes. Therefore, a rigorous postoperative surveillance is always justified. Being a safe tool with versatile diagnostic and therapeutic utilities, endoscopy deserves a central role in the physician's armamentarium in the postoperative management of esophageal reconstruction.