Alternative conduits for esophageal replacement become necessary when the stomach is unavailable for use. Common options for conduit creation include the jejunum and the colon. Prior abdominal operations , inflammatory bowel disease, or other mesenteric or abdominal disorders may limit use of either organ and a thorough history is essential when planning for alternative reconstruction. Most often the jejunum is free of intrinsic disease and provides a long segment for esophageal replacement. Limitations on the length of conduit that can be constructed with the jejunum have largely been overcome. A colonic conduit can also provide adequate length to reach the neck.