title: Mesenteric flap in free jejunal transfers: a versatile technique for head and neck reconstruction.
abstract: BACKGROUND
  The technique of free jejunal transfers has been widely used for pharyngoesophageal reconstruction. However, secondary infectious and fistulous complications may develop in extensive and preoperatively high-dose irradiated cases.
  
  
  METHODS
  A generous jejunomesenteric composite graft was harvested and the mesenterium was effectively applied for head and neck reconstruction.
  
  
  RESULTS
  The mesenteric flap connected with the revascularized jejunum was used as means for obliterating dead space in the head and neck region, as a cover for the cover for the cervical vessels, as a vascularized bolstering for the vascular and enteral anastomoses, or as a vascularized bed for skin grafting when the skin flaps are deficient. Only one small fistula occurred in 10 patients who underwent the mesenteric flap.
  
  
  CONCLUSIONS
  This versatile technique is expected to reduce the incidence of postoperative complications in pharyngoesophageal reconstruction using free jejunal transfers.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: K
authors.initials: K
authors.lastname: Nohira
authors.forename: Y
authors.initials: Y
authors.lastname: Shintomi
authors.forename: T
authors.initials: T
authors.lastname: Yoshida
authors.forename: H
authors.initials: H
authors.lastname: Minakawa
authors.forename: S
authors.initials: S
authors.lastname: Okushiba
authors.forename: S
authors.initials: S
authors.lastname: Fukuda
authors.forename: Y
authors.initials: Y
authors.lastname: Inuyama
authors.forename: M
authors.initials: M
authors.lastname: Hosokawa
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007013:Hypopharynx / Q000601:surgery; D007583:Jejunum; D008297:Male; D008643:Mesentery; D008722:Methods; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D013524:Surgical Flaps