Free jejunal transfer for pharyngo-esophageal reconstruction. 2002

H M Bhathena
Tata Memorial Cancer Hospital and Centre, Parel, Bombay, India. hoshi@vsnl.com

During the course of head and neck surgery for cancer the reconstructive surgeon is involved in replacement of pharyngeal mucosal defects. Siedenberg (7) first reported free transplantation in 1959 using a segment of jejunum, Roberts (5) using jejunum, Nakayama (3) using colon and Jurkiewicz (4) using ileum and jejunum. Green (2) in 1966 using microsurgical techniques demonstrated 100% survival of free transfers of jejunum and also patches of jejunum in dogs. We have used free interposing iso-peristaltic jejunal loop transfer in 30 patients to bridge the cervical esophagus defects for advanced cancer of hypopharynx, larynx and cervical esophagus after ablative cancer surgery. The major complication rate was 13% (4/30 cases) including total flap failure and loss of interposed jejunal segment. The minor complication rate was 36% (11/30 cases) including postoperative hypothyroidism in 2 patients. Intra-abdominal hemorrhage or peri-operative mortality was not observed in any of our cases. Total post-operative average hospital stay was 15 days, and median swallowing time was 10 days. Complication rates and success of early functional and social restoration have been analyzed.

UI MeSH Term Description Entries
D007012 Hypopharyngeal Neoplasms Tumors or cancer of the HYPOPHARYNX. Hypopharyngeal Cancer,Neoplasms, Hypopharyngeal,Cancer, Hypopharyngeal,Cancers, Hypopharyngeal,Hypopharyngeal Cancers,Hypopharyngeal Neoplasm,Neoplasm, Hypopharyngeal
D007583 Jejunum The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum. Jejunums
D007822 Laryngeal Neoplasms Cancers or tumors of the LARYNX or any of its parts: the GLOTTIS; EPIGLOTTIS; LARYNGEAL CARTILAGES; LARYNGEAL MUSCLES; and VOCAL CORDS. Cancer of Larynx,Laryngeal Cancer,Larynx Neoplasms,Cancer of the Larynx,Larynx Cancer,Neoplasms, Laryngeal,Cancer, Laryngeal,Cancer, Larynx,Cancers, Laryngeal,Cancers, Larynx,Laryngeal Cancers,Laryngeal Neoplasm,Larynx Cancers,Larynx Neoplasm,Neoplasm, Laryngeal,Neoplasm, Larynx,Neoplasms, Larynx
D008297 Male Males
D010614 Pharynx A funnel-shaped fibromuscular tube that conducts food to the ESOPHAGUS, and air to the LARYNX and LUNGS. It is located posterior to the NASAL CAVITY; ORAL CAVITY; and LARYNX, and extends from the SKULL BASE to the inferior border of the CRICOID CARTILAGE anteriorly and to the inferior border of the C6 vertebra posteriorly. It is divided into the NASOPHARYNX; OROPHARYNX; and HYPOPHARYNX (laryngopharynx). Throat,Pharynxs,Throats
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004938 Esophageal Neoplasms Tumors or cancer of the ESOPHAGUS. Cancer of Esophagus,Esophageal Cancer,Cancer of the Esophagus,Esophagus Cancer,Esophagus Neoplasm,Neoplasms, Esophageal,Cancer, Esophageal,Cancer, Esophagus,Cancers, Esophageal,Cancers, Esophagus,Esophageal Cancers,Esophageal Neoplasm,Esophagus Cancers,Esophagus Neoplasms,Neoplasm, Esophageal,Neoplasm, Esophagus,Neoplasms, Esophagus
D004944 Esophagoplasty A plastic operation on the esophagus. (Dorland, 28th ed) Esophagoplasties
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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