Document Detail


A revised method for pharyngoesophageal reconstruction using free jejunal transfer.
MedLine Citation:
PMID:  16327468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pharyngoesophageal reconstruction using free jejunal transfer is a reliable procedure, but the achievement of perfect functional results is still challenging. We present a devised method. Jejunoesophageal anastomosis is performed after 2 longitudinal incisions are made at the side corners of the esophageal stump. This maneuver not only enlarges the size of the esophageal stump but also provides a "Z-plasty-like" effect, which reduces the risk of delayed stricture formation. The pharyngojejunal anastomosis is performed in an end-to-end manner. Irrespective of the highest point of the pharyngeal defect, a longitudinal incision is made at the edge of the jejunal graft corresponding to the midpoint of the back wall of the pharyngeal stump. With this concept, considerable longitudinal tension is placed on the posterior side of the jejunal graft, whereas moderate tension is placed on the anterior side of the graft, which prevents the fistula formation that tends to occur in the anterior suture line. Twenty patients underwent the reconstruction using this operative procedure. In all cases, postoperative deglutition was satisfactory without jejunal redundancy or constriction. We believe that our method can be applied in most cases of pharyngoesophageal defects, providing simple and reasonable reconstruction using free jejunal transfer with stable results.
Authors:
Mutsumi Okazaki; Hirotaka Asato; Shunji Sarukawa; Masayuki Okochi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  55     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-03-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  643-7     Citation Subset:  IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. okazaki-m@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Combined Modality Therapy
Esophagus / surgery*
Female
Humans
Hypopharyngeal Neoplasms / radiotherapy,  surgery*
Male
Middle Aged
Pharynx / surgery*
Reconstructive Surgical Procedures / methods*
Suture Techniques

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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