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The free jejunal graft with microvascular anastomosis offers the head and neck surgeon a reliable, single-stage method of repair for small cervical defects and also for more extensive pharyngoesophageal defects where one or more loops of jejunum can successfully be used. If microvascular expertise is available, this method of reconstruction offers early alimentary rehabilitation and a physiologic repair. The free jejunal graft is a reliable method of reconstruction not only after failed gastric pull-up or when that procedure is not feasible, but also, where the facilities exist, as a primary method of pharyngoesophageal reconstruction.
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