Primary esophageal reconstruction after resection of the cancer in the hypopharynx or cervical esophagus: comparison of free forearm skin tube flap, free jejunal transplantation and pull-through esophagectomy.
Sixty-six patients with carcinoma of the hypopharynx or cervical esophagus received esophageal extraction and primary reconstruction. The methods of reconstruction were free forearm skin tube grafting, free jejunal transplantation and immediate pharyngo-gastrostomy after pull-through esophagectomy. Considering the postoperative complications of each method, free forearm skin tube transplantation is the safest, but it can only be used for a short defect of the esophagus. With pull-through esophagectomy, we are able to extract the whole esophagus and have no fear of leaving any remaining cancer in the thoracic esophagus, but the operative burden and the rate at which complications occur are higher. Free jejunal transplantation can be used for a short or long defect of the cervical esophagus with small operative burden. Among three methods of reconstruction, free jejunal transplantation is recommended for primary reconstruction of the cervical esophagus.
Kato
H
H
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Watanabe
H
H
Iizuka
T
T
Ebihara
S
S
Ono
I
I
Terui
S
S
Harii
K
K
D004938:Esophageal Neoplasms / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000601:surgery; D005542:Forearm; D006801:Humans; D007013:Hypopharynx / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D016038:Skin Transplantation