Fig. 4

Schema of the operation. The first surgical procedure involved PpPD and Child reconstruction with Braun anastomosis. We performed middle-lower esophagectomy and total gastectomy through a right thoracoabdominal incision. The transverse colon with the vascular pedicle of the left colic vessel was pulled up to the cut end of the esophagus through a hiatus. The anal cut end of the transverse colon was anastomosed to the jejunum in a Roux-Y fashion. Jejunojejunostomy was performed 40 cm from the anal side of the colonojejunostomy