Free jejunum transfers for functional reconstruction after tumour resections in the oral cavity and the pharynx: changes of morphology and function.
Oropharyngeal reconstruction following resections for locally advanced carcinoma by free jejunum transfer was studied in 31 consecutive cases over a period of 6 years, from 1988-1994. The most common site was the hypopharynx (n = 23). Reconstruction of the tonsillar region was performed in 5 cases and of the inner lining of the mouth in 5 cases. Two patients underwent neoglottic reconstruction, creating a tracheo-pharyngeal shunt. By use of an exteriorized jejunal segment for flap monitoring changes in morphology and function of a microvascular transferred denervated segment of jejunum could be monitored. The success rate was 94%. No evidence of fistula formation and local dehiscence were experienced in this series. Histological examinations showed some fibrotic changes 6 months after transplantation; lubrication and motility of the transplant were not severely altered. Biosynthesis, processing, and proteolytic activity of the jejunal epithelial cells were not impaired 2 weeks postoperatively.
Giovanoli
P
P
Department of Surgery, University Hospital Zürich, Switzerland.
Frey
M
M
Schmid
S
S
Flury
R
R
D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005355:Fibrosis; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000473:pathology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome