Jejunum free flap in hypopharynx reconstruction: case series.
BACKGROUND
Surgical treatment of hypopharyngeal cancers with extension to the retrocricoid region generally requires a circumferential pharyngolaryngectomy followed by a reconstruction of the removed segment of the upper digestive tract. Historically, many techniques have been used in order to achieve a safe and functional reconstruction. Jejunum interposition is generally considered the best reconstructive technique.


METHODS
This study examines the details of the surgical technique, the complications, the oncological and the functional results in a series of 29 consecutive patients submitted to circumferential pharyngoesophageal resection for advanced hypopharyngeal cancer followed by reconstruction with a free flap of jejunum.


RESULTS
Three of the transplants failed because of venous thrombosis. The overall success rate was 90%. There were no general complications. A good swallowing has been preserved in all our patients. All our patients where a phonatory prosthesis was positioned (20/29) were able to achieve speech following speech therapy and all were satisfied with their own capacity to communicate.


CONCLUSIONS
The prognosis of hypopharyngeal tumours (18-40% at 5 years) remains poor, but jejunum autografts are being shown to be an excellent choice for the reconstruction of the cervical hypopharyngo-oesophagus offering the patient fast rehabilitation and a reasonable quality of survival. Our experience confirm that this kind of reconstruction is safe with a good results in improving oncologic controls and restoring a good quality of life.
Benazzo
Marco
M
Dept, of Otorhinolaryngology, University of Pavia, IRCCS Policlinico S, Matteo, Pavia, Italy. m.benazzo@smatteo.pv.it
Occhini
Antonio
A
Rossi
Vanessa
V
Aresi
Giuseppe
G
Alessiani
Mario
M
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007013:Hypopharynx / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000534:rehabilitation; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D013064:Speech Disorders / Q000209:etiology / Q000534:rehabilitation; D013524:Surgical Flaps; D017211:Treatment Failure; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology