Complications associated with free jejunal graft reconstruction of the pharyngoesophagus—a multiinstitutional experience with 52 cases

Abstract

Fifty-two patients who underwent reconstruction of the pharynx and esophagus using the free jejunal graft were retrospectively reviewed. The complications were categorized into those associated with the resection, those associated with the harvesting of the graft, and those related to the reconstruction per se. In this series, the graft failure rate was 7.6% with an overall success rate of 90.3%. Graft necrosis was found to be the most serious complication occurring in four patients. Methods of detection of graft necrosis and management of these complications are discussed.

Partial vs Total Esophagectomy for Advanced Carcinoma of the Hypopharynx

“…20 The overall success rate of the procedure was 90.3% with two cases of graft failure necessitating alternate methods of reconstruction and two cases where the patients pre¬ ferred to use a gastrostomy for feed¬ ing, in spite of a patent and successful graft. The greatest confirmation of the success of this technique was the early rehabilitation obtained, the average hospital stay being 18 days with most being able to swallow well before discharge.20 COMMENT Review of the literature and the data presented suggests that in care¬ fully selected advanced carcinomas involving the hypopharynx, adequate local and regional control can be achieved with laryngopharyngectomy and partial esophagectomy.…”

Gastrointestinal reconstructions in 1200 patients with cancer at the pharyngesophageal junction

“…Free jejunal autograft follows pharyngolaryngectomy and cervical esophagectomy for more proximal carcinomas, involving the larynx, hypopharynx, and oropharynx [21,22,[33][34][35][36].…”

“…It is a reliable and safe technique as the jejunal segment can be distended, yet remaining its muscular tone [20,35,37]. Jejunum can be used in patients with previous gastric surgery, cardiopulmonary diseases, or laryngeal sparing resections, when gastric pull-up is not possible.…”

Zervikale Jejunuminterposition – Technik und Ergebnisse

“…Die arterielle Anastomose wird entweder mit Lupenbrille oder unter dem Operationsmikroskop mit 7.0-Na Èhten ausgefu È hrt. Nach [4] 1978 11 E/P/L 9 9 9 McConnel et al [5] 1981 20 P x 13 13 0 7 Robinson et al [6] 1982 21 E/P x 5 Hester et al [7] 1984 50 E/P x 11 0 5 Berger et al [8] 1984 11 E/P 7 Nozaki et al [9] 1985 29 E/P x 0 0 Fisher et al [10] 1985 40 E/P x 7 20 20 10 Gluckmann et al [11] 1985 52 P 10 8 11 0 Biel et al [12] 1987 17 E/P x 35 18 18 18 Coleman et al [13] 1987 96 P/L x 32 13 7 6 Kato et al [14] 1987 21 E/P 33 5 McDonough et al [15] 1988 42 P x 9 9 Flynn et al [16] 1989 35 E/P/L x 3 8 Germain et al [17] 1990 90 P 0 Schustermann et al [18] 1990 50 E/P/L x 16 6 22 2 Peracchia et al [19] 1990 23 E/P x 21 9 6 Carlson et al [20] 1992 25 E/P x 20 4 16 0 Omura et al [21] 1994 24 E/P 8 0 4 8 Triboulet et al [22] 1994 59 P x 15 5 3…”