Comparison of the outcomes of free jejunal flap reconstructions of pharyngoesophageal defects in hypopharyngeal cancer and corrosive injury patients

Abstract

Postoperative early stricture but lower fistula occurrence is expected in patients with corrosively injured esophagi. This helpful preliminary findings could not only early-check complication, but also better explanation and prepare were taken placed before operation.

Treatment for postchemoradiotherapy hypopharyngeal stenosis: Pharyngoesophageal bypass using an anterolateral thigh flap—A case report

“…In reconstructions performed with a jejunal flap, the stenosis rate was less compared with those performed with ALT and forearm flaps ( p = .0093). For jejunal flaps, Hsieh et al () describe an overall rate of fistulas of 20% and 31% in stenosis due to hypopharyngeal carcinomas, similar to the rates described by Tan et al (). However, their overall graft loss was 8%.…”

“…When dilatation attempts fail, further surgical treatment may imply organ resection, complex reconstructive procedures, and functional disabilities. These complex procedures include the following options: sternocleidomastoid myocutaneous flap (Paknezhad, Borchard, & Lee, ), jejunal (Clark et al, ; Hsieh, Yang, Tsai, Kuo, & Lin, ; Tan et al, ; Welkoborsky, Deichmuller, Bauer, & Hinni, ; Yu, Lewin, Reece, & Robb, ); radial forearm (Clark et al, ; Tan et al, ); anterolateral thigh (ALT) flap (Clark et al, ; Piazza, Taglietti, & Nicolai, ; Tan et al, ; Yu et al, ); rectus abdominis (Clark et al, ); gastro‐omental flaps (Clark et al, ); and colon transpositions (Banerjee & Saranga Bharathi, ; Tettey et al, ).…”

Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy

“…Following pharyngoesophagectomy, alimentary tract reconstruction is performed using visceral (e.g., stomach, jejunum, and colon), musculocutaneous, or fasciocutaneous flaps in order to restore the continuity of the digestive tract (Hsieh, Yang, Tsai, Kuo, & Lin, 2017;Orringer, 1992). In particular, the use of free jejunal flaps has been considered reliable due to low complication rates and low donor site morbidity (Okazaki, Asato, Okochi, & Suga, 2007;Razdan, Albornoz, Matros, Paty, & Cordeiro, 2015) with high overall success rates of 92%-97% (Chan, Ng, Liu, Chung, & Wei, 2011;Hsieh et al, 2017;Nakatsuka et al, 1998;Nakatsuka et al, 2003;Okazaki et al, 2007;Sugiyama, Takao, Suzuki, & Kimata, 2016;Yu, Lewin, Reece, & Robb, 2006). We aimed to achieve restoration of digestive tract continuity in conjunction with anterior mediastinal tracheostomy using a novel 1-stage technique to reconstruct both the trachea and alimentary tract, although 2-stage reconstruction is sometimes used given the complexity of combined tracheal and esophageal reconstruction (Ghali et al, 2015).…”

Free jejunal flap transfer with multiple vascular pedicles for safe and reliable pharyngoesophageal reconstruction

“…1,2 Free jejunal flap transfer has been considered a reliable procedure for pharyngoesophageal reconstruction due to its low complication rate and low donor site morbidity, 2,3 with low overall failure rates of 3%-8%. The primary goal of pharyngoesophageal reconstruction is to restore continuity of the aerodigestive tract, using free fasciocutaneous or visceral flaps, and to improve the quality of life by maximizing speech and swallow function.…”

“…The primary goal of pharyngoesophageal reconstruction is to restore continuity of the aerodigestive tract, using free fasciocutaneous or visceral flaps, and to improve the quality of life by maximizing speech and swallow function. 1,2 Free jejunal flap transfer has been considered a reliable procedure for pharyngoesophageal reconstruction due to its low complication rate and low donor site morbidity, 2,3 with low overall failure rates of 3%-8%. 1,[3][4][5][6][7][8] However, total flap loss due to vascular occlusion (ie, the most devastating outcome in free tissue transfer), cannot always be avoided.…”