title: [Reconstruction with free jejunal interposition for defect after tumor resection of hypopharyngeal and cervical esophageal cancer].
abstract: OBJECTIVE
  To discuss the use of free jejunal flap in reconstruction for circumferential defect after tumor resection of hypopharyngeal and cervical esophageal cancer.
  
  
  METHODS
  Retrospective review of 51 patients who underwent circumferential pharyngoesophageal reconstruction with free jejunal flap after tumor ablation.
  
  
  RESULTS
  In 51 patients, 5 had flap failure and the flap success rate was 90% (46/51). Forty-five patients had oral intake after operation excluding one who had anastomosis stenosis and 5 who had flap failure. The 1-year and 3-year survival rate was 62% and 48% respectively. Positive surgical marginal status and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area were indicators for bad prognosis. Except 5 patients who had flap failure, one of which died from mediastinal infection, no other severe complications occurred.
  
  
  CONCLUSIONS
  Patients reconstructed with free jejunal flap after resection of hypopharyngeal and cervical esophageal cancer had low mortality and few complications. Those without positive surgical margin and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area had higher survival rate. Most of them had good quality of life. The choice of free jejunal flap for reconstruction of hypopharyngoesophageal defect was appropriate in selected patients who had guarantee of negative surgical margin and no external invasion.
authors.affiliation: Department of Head and Neck Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China. dezhil@163.net
authors.forename: De-zhi
authors.initials: DZ
authors.lastname: Li
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Xu
authors.forename: Yong-fa
authors.initials: YF
authors.lastname: Qi
authors.forename: Ping-zhang
authors.initials: PZ
authors.lastname: Tang
authors.forename: Yue-huang
authors.initials: YH
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Xue-xi
authors.initials: XX
authors.lastname: Wu
authors.forename: Shao-yan
authors.initials: SY
authors.lastname: Liu
authors.forename: Chi
authors.initials: C
authors.lastname: Mao
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate