Esophagus reconstruction with free jejunal transfer.
Following pharyngolaryngectomy, reconstruction is one of the most challenging surgical procedures. Here we review our own experiences using a microvascularly transferred free jejunal graft. This method was performed in 22 patients (19 male and 3 female, aged 40-63 years). Seven patients underwent neoadjuvant chemo-radiotherapy. Eighteen patients had immediate reconstruction after pharyngolaryngectomy, and 4 patients had delayed reconstruction because of complications from previous surgeries (2 stenoses, and 2 recurrent cancers). The duration of surgery ranged from 5-9 h (mean, 6.3 h), and the ischemic time of the graft was 70-125 min (mean, 88 min). This method has several advantages: it is a one-step operation; the graft is covered by self-cleaning mucosa; the development of fistulas and stenoses is rare; and the technique provides good swallowing. Owing to its good blood supply, this reconstructive method can also be used in previously irradiated areas.
Pavlovics
Gabor
G
Department of Surgery, Medical School, University of Pecs, Pecs, Hungary. gabor.pavlovics@aok.pte.hu
Cseke
Laszlo
L
Papp
Andras
A
Tizedes
Gyorgy
G
Tabar
Bela A
BA
Horvath
Peter Ors
PO
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000098:blood supply* / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000098:blood supply* / Q000637:transplantation*; D007825:Laryngectomy; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010611:Pharyngectomy; D012189:Retrospective Studies; D016896:Treatment Outcome