[Possible variations of free autogenous jejunum transplantation for differential reconstruction of the oropharynx].
BACKGROUND
Resections of extensive tumours, recurrences and radiodermatitides at the neck cause complex defects. Free bowel transplantation enables one-stage reconstruction.


METHODS
In 35 out of 57 interdisciplinarily treated patients, small-bowel transplantation was performed for reconstruction. Thirty patients received cylinder grafts, five jejunal patch plastics. In four patients neoglottis formations according to Ehrenberger were performed. To cover soft tissue defects, two patients received scapular free flaps, eight patients a jejunal segment, incised at the anti-mesenteric side, the mucosa stripped and covered by a split skin graft.


CONCLUSIONS
Thirty-four grafts were viable. One patient received a successful re-transplantation. One postoperative fistula at the hypo-pharyngojejunostomy was closed by a separated jejunal segment which was primarily used as monitor, two others by pectoral flaps. Separation of a jejunal graft into two or three segments enables restoration of swallowing, voice and covering soft tissue in a one-stage procedure. The whole reconstruction necessitates only one arterial and one venous microanastomosis at the neck.
Frick
A
A
Chirurgische Klinik und Poliklinik Grosshadern, Universität München.
Baumeister
R G
RG
Mees
K
K
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps; D013536:Suture Techniques; D014139:Tracheostomy; D016896:Treatment Outcome
Variationsmöglichkeiten der freien autogenen Jejunumtransplantation zur differenzierten Rekonstruktion des Oropharynx.