title: Free vascularized jejunum interposition for pharyngoesophageal reconstruction after total laryngopharyngectomy.
abstract: The records of 28 patients who underwent free jejunal graft reconstruction after resection for cancer involving the pharynx were analysed. Seven patients had a T3 carcinoma, 15 patients T4 and six patients recurrence after laryngectomy. Ten patients had received radiotherapy in the past. Post-operatively, 15 patients (54%) had complications and two patients (7%) died. No significant difference was observed in the complication rate between the group that received radiotherapy in the past and those who did not. Nineteen patients received post-operative radiotherapy. Nine patients had no radiotherapy on the basis of complete resection or because of serious complications. For the whole group the 2-year recurrence free period and survival were 42% and 51% respectively. The post-operative radiotherapy group had a significantly better survival (73%) and recurrence free period (63%) than the group without post-operative radiotherapy (0%). Thus, post-operative radiotherapy seems indicated irrespective of resection margins.
authors.affiliation: Department of Oto-Rhino-Laryngology Head & Neck Surgery, Free University, Amsterdam, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Hoorweg
authors.forename: J A
authors.initials: JA
authors.lastname: Rauwerda
authors.forename: G A
authors.initials: GA
authors.lastname: Croll
authors.forename: A J
authors.initials: AJ
authors.lastname: Mackaay
authors.forename: E K
authors.initials: EK
authors.lastname: Risse
authors.forename: N
authors.initials: N
authors.lastname: De Vries
authors.forename: R M
authors.initials: RM
authors.lastname: Tiwari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D017577:Cutaneous Fistula / Q000209:etiology; D018572:Disease-Free Survival; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000209:etiology; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy / Q000379:methods / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000209:etiology; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D010611:Pharyngectomy / Q000379:methods / Q000534:rehabilitation*; D010614:Pharynx / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate