title: Jejunal interposition for repair of stricture or fistula after laryngectomy.
abstract: Complications following total laryngectomy may include pharyngocutaneous fistula or pharyngeal stricture. Traditional techniques of repair of fistula and stricture with local or regional flaps lead to a high rate of failure. In this study, we report 18 patients treated by secondary jejunal interposition (JI) to rehabilitate swallowing following recalcitrant postlaryngectomy stricture or fistula. All patients had undergone total laryngectomy with or without partial pharyngectomy for treatment of squamous cell carcinoma of the larynx (8) or hypopharynx (10). Four were stage II; 5, stage III; and 9, stage IV. Thirteen patients (72%) regained swallowing function. Complications of secondary JI included perioperative death (2), flap loss (1), and persistent fistulas (3). Jejunal interposition may be the best modality in the rehabilitation of swallowing in patients with persistent fistula or stricture that fails to respond to traditional management.
authors.affiliation: Department of Otolaryngology, Eye and Ear Hospital, University of Pittsburgh School of Medicine, Pennsylvania.
authors.forename: E J
authors.initials: EJ
authors.lastname: de Vries
authors.forename: E N
authors.initials: EN
authors.lastname: Myers
authors.forename: J T
authors.initials: JT
authors.lastname: Johnson
authors.forename: K
authors.initials: K
authors.lastname: Shestak
authors.forename: M A
authors.initials: MA
authors.lastname: Schusterman
authors.forename: G J
authors.initials: GJ
authors.lastname: Petruzzelli
authors.forename: N F
authors.initials: NF
authors.lastname: Jones
authors.forename: R
authors.initials: R
authors.lastname: Wagner
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007583:Jejunum / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008722:Methods; D009333:Neck; D010608:Pharyngeal Diseases / Q000209:etiology / Q000601:surgery*; D010611:Pharyngectomy; D011183:Postoperative Complications; D012871:Skin Diseases / Q000209:etiology / Q000601:surgery