Repositioning the stoma of the cervical esophagostomy

The stoma created with a diverting cervical esophagostomy is often an unsightly inconvenience for the patient because of the high incidence of leakage from the collecting appliance. Secure attachment of a collection device at the base of the neck is difficult. The stoma of the cervical esophagostomy may be moved away from the base of the neck using a tubed skin flap modeled after that originally described by Wookey. Such a procedure has the advantages of removing the appliance from an area of high visibility and providing a flatter base that decreases leakage and soiling. We advocate this simple procedure in patients who desire to rid themselves of a cervical appliance, but who are poor operative candidates for a more extensive procedure replacing the entire esophagus.