Esophagectomy and gastric pull-up in patients with previous free jejunal transfer.
Several options exist for reconstruction after total esophagectomy in patients with esophageal carcinoma. However, the options for a major resection after previous head and neck surgery in these patients are extremely limited. The procedure performed in 2 patients requiring esophagectomy after resection for previous head and neck malignancies is described. Both patients underwent previous chemoradiation therapy and free jejunal transfer for hypopharyngeal squamous cell carcinoma. Esophagectomy and reconstruction with a cervical gastrojejunal anastomosis combined with deltopectoral flaps were performed after the diagnosis of esophageal disease. Soft tissue defects were closed with a modified deltopectoral flap using de-epithelization. The deltopectoral flap is effective not only for cutaneous resurfacing, but also to promote delayed wound healing after radiation therapy. This report demonstrates a useful multidisciplinary approach for resection and reconstruction in patients after a previous free jejunal transfer.
Hosoya
Yoshinori
Y
Department of Surgery, Jichi Medical University, Tochigi, Japan. hosoyo@jichi.ac.jp
Sarukawa
Shunji
S
Matsumoto
Shiro
S
Zuiki
Toru
T
Hyodo
Masanobu
M
Abe
Koichi
K
Nishino
Hiroshi
H
Sugawara
Yasushi
Y
Lefor
Alan T
AT
Yasuda
Yoshikazu
Y
D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000628:therapy; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D018570:Risk Assessment; D013270:Stomach / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome