title: Salvage Procedures after Total Necrosis of a Free Jejunal Graft.
abstract: OBJECTIVE
  To determine the appropriate salvage method after total necrosis of a jejunal graft after reconstruction of total laryngopharyngoesophagectomy or a larynx-preserving operation, considering the complexity of medical service in China.
  
  
  METHODS
  We reviewed 5 patients with a mean age of 61 years who developed total jejunal graft necrosis and underwent reconstruction of a free jejunal transfer in our hospital. The total number and choice of salvage procedures, the symptoms and the results of salvage for the 5 patients have been reviewed.
  
  
  RESULTS
  Four of the 5 patients survived. One of them underwent gastric pull-up reconstruction and recovered well. One patient died due to severe infection after the loss of the jejunal graft and secondary gastric pull-up reconstruction. A temporary external fistula was formed in 3 patients after the initial jejunal graft necrosis, 2 of which underwent fistula repair 6 and 5 months later, while one went on long-term gastric tube feeding.
  
  
  CONCLUSIONS
  Our results suggest that a temporary external fistula formation is an optional secondary salvage procedure after total necrosis of an initial jejunal graft, considering the relatively low quality of medical service in China.
authors: Department of Head and Neck Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors: Song
authors: S
authors: Ni
authors: Yiming
authors: Y
authors: Zhu
authors: Jian
authors: J
authors: Wang
authors: Dezhi
authors: D
authors: Li
authors: Bin
authors: B
authors: Zhang
authors: Zhengang
authors: Z
authors: Xu
authors: Shaoyan
authors: S
authors: Liu
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000473:pathology; D006084:Graft Rejection; D006801:Humans; D007583:Jejunum / Q000473:pathology / Q000637:transplantation*; D007825:Laryngectomy / Q000009:adverse effects; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000601:surgery; D010611:Pharyngectomy / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*