[The carotid artery as recipient vessel: troubleshooting for free jejunal transfer after esophagectomy in preradiated patients].
BACKGROUND
In the treatment of esophageal cancer neoadjuvant radiotherapy often leads to vascular damage of the usual recipient arteries for free jejunal transfer. End-to-side anastomosis to the carotid artery could be a potential alternative.


METHODS
A total of 70 patients with locally advanced carcinoma of the esophagus underwent esophagectomy after neoadjuvant radiochemotherapy. In all patients reconstruction was carried out with a free jejunal transfer. Smaller vessels could be used for anastomoses in 54 of these patients and in 16 cases the jejunal flap artery was attached to the carotid artery.


RESULTS
Out of 54 patients 9 (17%) with microvascular anastomoses to the smaller vessels needed surgical intervention for ischemia. In 16 patients with anastomosis to the carotid artery no significant failure of perfusion occurred.


CONCLUSIONS
The carotid artery as recipient vessel in free jejunal transfer seems to be a safe therapeutic option for intestinal reconstruction of preradiated esophageal cancer with good functional results.
Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, Ismaninger Strasse 22, Munich, Germany. daniel.mueller@lrz.tu-muenchen.de
D F
DF
Müller
J A
JA
Lohmeyer
A
A
Zimmermann
J R
JR
Siewert
L
L
Kovacs
H-G
HG
Machens
E
E
Biemer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D001158:Arteries / Q000528:radiation effects / Q000601:surgery; D017536:Carotid Artery, Common / Q000601:surgery*; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000098:blood supply; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000601:surgery; D011832:Radiation Injuries / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D014680:Veins / Q000528:radiation effects / Q000601:surgery; D055815:Young Adult
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