Free jejunum reconstruction of upper esophageal defects

Abstract

The free jejunum has become an important method for reconstructing extensive oncologic defects of the upper esophagus and pharynx. The advantages of a single-staged reconstruction with a low incidence of morbidity have generally outweighed criticisms such as the requirement for a laparotomy and poor voice quality. The aim of the study was to present the technique and outcomes of free jejunal reconstruction of the upper esophagus in 31 consecutive cases. We reviewed our experience of free jejunal flaps undertaken over a 6-year period. Our surgical approach, complications, and results of swallow and speech restoration are described. A functional swallow was achieved by 27/31 patients. However, satisfactory voice restoration was seen in only a small proportion of patients. Complications at the donor site occurred in just one patient. The current review confirms the jejunal flap as a reliable reconstructive option with minimal donor site morbidity.

Safety of intra‐operative vasopressor in free jejunal flap reconstruction

“…The free jejunal flap is a popular reconstructive option for pharyngo–esophageal defects after tumor extirpation . However, as a visceral flap, it is sensitive to prolonged ischemic time and fluctuations in vascular perfusion.…”

Free jejunal flap transfer for pharyngoesophageal reconstruction in patients with intestinal malrotation: Two case reports

“…Although various reconstruction techniques have been described, those currently performed are mainly of two types: the free jejunal flap and the tubed fasciocutaneous free flap . There have been a number of reports comparing these reconstruction tequniques . The advantages of free jejunal flap reconstruction are good swallowing function, a low pharyngocutaneous fistula rate, and a low anastomotic stricture rate, while the disadvantage is the relatively poor suitability for voice rehabilitation .…”

“…[1][2][3][4] There have been a number of reports comparing these reconstruction tequniques. 1,[3][4][5] The advantages of free jejunal flap reconstruction are good swallowing function, a low pharyngocutaneous fistula rate, and a low anastomotic stricture rate, while the disadvantage is the relatively poor suitability for voice rehabilitation. 5,6 Despite this disadvantage, the free jejunal flap currently remains the method of choice in pharyngoesophageal reconstruction.…”

“…1,[3][4][5] The advantages of free jejunal flap reconstruction are good swallowing function, a low pharyngocutaneous fistula rate, and a low anastomotic stricture rate, while the disadvantage is the relatively poor suitability for voice rehabilitation. 5,6 Despite this disadvantage, the free jejunal flap currently remains the method of choice in pharyngoesophageal reconstruction. 1,2,5,6 Intestinal malrotation results from failure of normal intestinal rotation and fixation.…”

“…5,6 Despite this disadvantage, the free jejunal flap currently remains the method of choice in pharyngoesophageal reconstruction. 1,2,5,6 Intestinal malrotation results from failure of normal intestinal rotation and fixation. Most intestinal malrotations are diagnosed with intestinal obstruction within the first year of life; this condition is very rarely diagnosed in adults.…”