[Choice of the 3d portion of the jejunum for reconstruction of the pharynx in circular pharyngolaryngectomies. Indications and advantages].
Many procedures are used for reconstruction of a pharyngeal gutter after circular pharyngolaryngectomy, interrupter of digestive continuity. The operation chosen was used of third part of jejunum for reconstruction, and its indications and limitations are described. The choice was based on anatomic data from dissection of 100 cadavers and values for different measurements performed (length of transplant, height of mesentery, caliber and length of vessels), and more particularly on constancy and reliability of vascularization of this digestive segment. To these advantages are added bacteriologic, technical, histologic and physiologic reasons. Results are analyzed of 11 operations carried out in the same department, from among a larger group comprising now 45 cases. Postoperative course was usually uncomplicated with rapid restoration of deglutition (a mean of 11.77 days in 9 of the 11 cases). Preoperative radiotherapy is not a contraindication and postoperative radiotherapy should be given routinely as a complement to surgery. It is usually well tolerated and transplant necrosis is not provoked. Nevertheless, the seriousness of this type of lesion is underlined by the high incidence of carcinologic failures, with an elevated risk of local and regional recurrence and of distant metastases.
D000368:Aged; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D010611:Pharyngectomy / Q000379:methods; D010614:Pharynx / Q000601:surgery*
Le choix du troisième jéjunum comme procédé de reconstitution du pharynx dans les pharyngo-laryngectomies circulaires. Indications et avantages.