A CLINICAL STUDY OF FREE JEJUNAL TRANSFER FOR ESOPHAGEAL RECONSTRUCTION

Abstract

Seventee cases of free jejunal transfer for esophageal reconstruction were subjected to a study comparing for resection and reconstruction procedures, postoperative complications, and prognosis. In eight cases of carcinoma involving the pharynx or cervical esophagus a free jejunal transfer following pharyngolaryngoesophagectomy coluld be termed typical operation, while other types of resection and reconstruction in nine cases involving double carcinoma cases of the hypopharynx and thoracic esophagus or recurrence cases following thyroidectomy for a carcinoma or esophagectomy for a carcinoma of the thoracic esophagus could be termed atypical operation. The internal jugular vein and the common carotid artery were the donor vessels of mainly choice. Comparison of the postoperative complications inthe two groups showed a significant difference. In the typical operation there were no postoperative complications, but in the atypical operation five cases developed postoperative complications involving one case of jejunal graft necrosis, three cases of intestinal suture insufficiency, and two cases of aspiration pneumonia. The median survival time of all cases was eighteen months, there was no significant difference between two groups in the prognosis. These results suggest that it is necessary to choose the optimal technique for each patient in order to improve the therapeutict results, especially for the atypical operation.