[Preservative measures for blood supply to jejunal segment in reconstruction of esophagus].
OBJECTIVE
To study the effective protective measures to ensure sufficient blood supply to the jejunal segment in reconstruction of esophagus.


METHODS
According to evidence based on medicine, we analyzed retrospectively 69 patients (48 cicatricial stenosis due to chemical burn, 21 defects due to excision of esophagus cancer), whose esophagus were reconstructed with free jejunal graft(in 28 cases) and with pedicle jejunal graft (in 41 cases) from 1980 to 2001.


RESULTS
All patients were followed up for 1-21 years. Of 43 patients treated before 1996, 5 complicated by anastomotic leakage, 1 by strangulated intestinal obstruction; of 26 patients treated after 1996 (6 with free jejunal graft, 20 with pedicle jejunal graft), only one case complicated by anastomotic leakage.


CONCLUSIONS
The preservative measures for good blood supply to the jejunal segment include the following aspects: (1) complete marginal vascular arcade without tension in the mesojejunum; (2) vessel anastomosis smooth; (3) 4-finger width pathway of jejunum; (4) the stable arterial blood pressure (more than 8 kPa); (5) a single-row anastomosis; and (6) the comprehensive preoperative management.
Sun
Qiang
Q
Department of Thoracic-Cardiovascular Surgery, 401st Hospital of PLA, Qingdao, Shandong, P. R. China, 266071.
Ma
Chun-shan
CS
Duan
Zhen-quan
ZQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000601:surgery; D004944:Esophagoplasty / Q000379:methods; D004947:Esophagus / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000098:blood supply / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies