Microvascular salvage for failed colonic interposition.
Free revascularized jejunal grafts have been used in three patients to restore alimentary tract continuity after ischaemic failure of pedicled colonic graft replacements of the oesophagus. In all three patients colon had been placed retrosternally. In one patient immediate replacement of a totally necrotic colon interposition was undertaken. In two patients, late long strictures were replaced by jejunal segments. Access to the retrosternal colon was gained in each case by neck and median sternotomy incisions. Revascularization of the jejunal segments was from the facial artery and external jugular vein in two patients and from the internal mammary vessels in one. Satisfactory swallowing of solids and liquids has been achieved and sustained.
Princess Alexandra Hospital, Brisbane, Queensland, Australia.
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DE
Theile
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Robinson
D000328:Adult; D000368:Aged; D003106:Colon / Q000473:pathology / Q000637:transplantation*; D004940:Esophageal Stenosis / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply / Q000637:transplantation; D007583:Jejunum / Q000098:blood supply / Q000637:transplantation*; D008297:Male; D008722:Methods; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications; D012086:Reoperation