A Retrospective Study of 66 Esophageal Reconstructions Using Microvascular Anastomoses

Free jejunal graft for hypopharyngeal and esophageal reconstruction

“…It is thought that, besides its protective function and the restoration of gastrointestinal continuity, the jejunal segment can function as a valve and prevent reflux of digestive juice [13]. The rate of post-operative complications in our patients was 9.3% (five patients), which, if compared with other reports of up to 25% [14], is considerably low. Nevertheless, the low rate of failure (3%-10%), low mortality and short-time hospitalization that has also been reported in previous studies [8,11,15] have convinced us that this is the best method to reconstruct hypopharynx and cervical esophagus after wide resections, and that is an invaluable technique in special cases, specially when stomach or colon are not available.…”

Colonic interposition and supercharge for esophageal reconstruction

“…Colonic interposition is a very useful technique that has gained wide acceptance in esophageal reconstruction for postgastrectomy patients [1][2][3][4][5][6]. The improvement in microsurgical techniques and availability of high-quality equipment has improved the safety of this technique [8][9][10][11]. It has certain advantages over previously used techniques, including its being a single-stage operation, with subsequent low morbidity and mortality and shorter length of hospitalization [13][14][15][16][17][18][19][20][21].…”

“…We therefore adopted the supercharge technique in many cases to improve blood flow through the intestine used for reconstruction of the esophagus. Despite the multistep nature of this operation procedure, we incurred no perioperative complications and have the safety postoperative course as reported by the past studies [8][9][10][11]. We performed colonic reconstruction with preservation of the stomach and vagus in 3 patients, each of whom had a good postoperative recovery.…”

A “watch window” technique for monitoring buried free jejunum flaps during circumferential pharyngolaryngectomy reconstruction

“…The free jejunum flap technique has been regarded as the optimal approach during circumferential pharyngolaryngectomy reconstruction, as has been reported by several authors [1][2][3][4]. The most serious complication is failure of vascular anastomosis, resulting in graft necrosis.…”