This chapter includes algorithms to manage some of the most challenging scenarios in oesophagogastric surgery. Early recognition, intervention and effective management of conditions and complicationsComplications that may ultimately require oesophageal reconstructionOesophageal reconstruction is emphasised. While the chapter includes several algorithms addressing common scenarios, it acknowledges the impossibility of covering every potential presentation. Emphasizing the pivotal role of multidisciplinary teamsMultidisciplinary team (MDT) (MDTs) in treatment decisions, the chapter highlights the nuanced approach needed for each case. Furthermore, it anticipates that advances in artificial intelligence (AI) will enable personalised management of many of the scenarios described.