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.
Department of Plastic and Reconstructive Surgery, School of Medicine, Hokkaido University, Sapporo, Japan.
Y
Y
Yamamoto
S
S
Sasaki
H
H
Furukawa
S
S
Okushiba
K
K
Ohno
T
T
Sugihara
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