Reconstruction methods after total pharyngolaryngoesophagectomy: free jejunal graft and venous-reconstructed gastric tube or gastric tube alone.
OBJECTIVE
The aim of this study is to assess the postoperative outcome of the two reconstruction methods using both a free jejunal graft and a venous-reconstructed gastric tube or a gastric tube alone after total pharyngolaryngoesophagectomy.


METHODS
We reconstructed the pharyngoesophagus using both a free jejunal graft and a gastric tube in 5 cases (JG group), including 4 in whom the gastric vein was reconstructed, and using a gastric tube alone in 8 cases (G group). We compared the two groups in terms of postoperative complications, operation time, blood loss and length of postoperative hospital stay.


RESULTS
In the JG group, jejunal graft necrosis occurred in a case, although 4 cases with gastric venous reconstruction had no postoperative problems. In the G group, although anastomotic trouble occurred in 3 cases, 7 patients were discharged from hospital with oral feeding. In the JG group, postoperative stay was shorter, but the operation time was longer, than those in the G group.


CONCLUSIONS
Reconstruction using a free jejunal graft and a venous-reconstructed gastric tube is useful especially for patients with a long defect in the pharyngoesophagus. These 2 methods may be used according to the length of the pharyngoesophageal defect.
Nomura
Takashi
T
Department of Gastroenterological and General Surgery, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata 990-9585, Japan.
Hachiya
Osamu
O
Suzuki
Akihiko
A
Kikuchi
Noriaki
N
Koike
Syuji
S
Fuse
Akira
A
Kimura
Wataru
W
D000714:Anastomosis, Surgical; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D014680:Veins / Q000601:surgery