CERVICAL ESOPHAGEAL RECONSTRUCTION USING FUNNEL-SHAPED FREE JEJUNAL FLAP AND POSTOPERATIVE EVALUATION OF SWALLOWING FUNCTION

Classified broadly, the typical materials used for reconstruction of the cervical esophageal are the gastric tube or free jejunal graft utilizing the gastrointestinal tract, and the pectoralis major myocutaneous flap, D-P flap, and forearm flap using the skin flaps. Free jejunal graft is probably th...

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Veröffentlicht in:Toukeibu Gan 2005/04/15, Vol.31(1), pp.107-112
Hauptverfasser: SAKAI, Naohiko, NAKAYAMA, Meijin, KOBAYASHI, Nobuyuki, HASHIMOTO, Nobuko, TAKEDA, Masahiko, YASUDA, Yoshihiro, OKAMOTO, Makito, UCHINUMA, Eijyu
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Sprache:jpn
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Zusammenfassung:Classified broadly, the typical materials used for reconstruction of the cervical esophageal are the gastric tube or free jejunal graft utilizing the gastrointestinal tract, and the pectoralis major myocutaneous flap, D-P flap, and forearm flap using the skin flaps. Free jejunal graft is probably the predominant method now for reconstruction. The advantages of jejunal grafting are fewer fistulae and less suture failure, and the possibility of oral intake soon after surgery, compared with reconstructive esophagus using a skin flap. On the other hand, the disadvantages are passage blockage due to peristalsis and the necessity for performing anastomosis because of a difference in pharyngeal aperture. To date we have also been reconstructing the esophagus using a reverse L-shaped or ρ-shaped bowel model, but we have experienced difficulties with swallowing disorders or reflux phenomena attributed to passage blockage caused by kinking, pooling and peristalsis. Thinking that a funnel shape would provide the best passage, we reconstructed the esophagus using a funnel-shaped jejunal model following laryngopharyngocervical esophagectomy and evaluated swallowing function following esophageal reconstruction. We report the good results obtained by this method.
ISSN:1349-5747
1881-8382
DOI:10.5981/jjhnc.31.107