title: [Preservative measures for blood supply to jejunal segment in reconstruction of esophagus].
abstract: 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.
authors.affiliation: Department of Thoracic-Cardiovascular Surgery, 401st Hospital of PLA, Qingdao, Shandong, P. R. China, 266071.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Sun
authors.forename: Chun-shan
authors.initials: CS
authors.lastname: Ma
authors.forename: Zhen-quan
authors.initials: ZQ
authors.lastname: Duan
mesh_terms: 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