Over a period of 13 years, 1,421 cases of pharyngoesophageal cancer were seen and treated. In 221 patients jejunal replacement of the esophagus—after resection or as bypass—was done. Technically, this procedure was possible in almost all patients including those who were obese. The operative technique must be meticulous as it is much more difficult to handle the small bowel than the colon. The overall hospital mortality was 38.6%. Many survived for more than 30 days, and in 2 the cause of death was malignant cachexia.