Microsurgical reconstruction of the digestive tract following pharyngolaryngectomy and total esophagectomy.
Total pharyngoesophageal reconstruction has remained a challenging field in digestive surgery. During the past 3 years, the authors performed six microsurgical reconstructions of the digestive tract following pharyngolaryngectomy and total esophagectomy due to a multiple cancer or skip metastasis. Digestive continuity was restored using a combination of a pulled-up gastric pedicle and free jejunal transfer in 2 patients, and an elongated gastric pedicle with microvascular augmentation in 4 patients. One elongated gastric pedicle developed partial necrosis, and a free jejunal graft was placed additionally. One patient suffered from respiratory dysfunction and died 1 month after surgery. Postoperative radiographic examination showed a good swallowing mechanism without reflux and stasis in all patients. Microvascular surgery contributes to the successful reconstruction of the digestive tract following extensive pharyngolaryngoesophagectomy.
Yamamoto
Y
Y
Department of Plastic and Reconstructive Surgery, School of Medicine, Hokkaido University, Sapporo, Japan.
Sasaki
S
S
Furukawa
H
H
Okushiba
S
S
Ohno
K
K
Sugihara
T
T
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D010611:Pharyngectomy; D019738:Surgically-Created Structures