Free jejunal graft reconstruction of the alimentary tract

Abstract

Free jejunal transfer is the procedure of choice in total pharyngolaryngectomy for hypopharyngeal cancer and severe postoperative stenosis. Recipient vessels in the neck must be prepared during the harvesting of a segment of bowel 10 to 14 cm in length isolated on its pedicle. After the anastomosis to the hypopharyngeal inlet is completed, the microvascular anastomoses are done, first the vein and then the artery. Previously operated and irradiated necks raise important problems in the performance of the anastomosis that have to be solved. Finally, the distal part of the bowel is anastomosed to the cervical esophagus.