Complications of free jejunal transfer reconstruction for total pharyngolaryngoesophagectomy

Free jejuna transfer has become a first choice for pharyngoesophageal reconstruction. We reviewed 90 consecutive patients who underwent pharyngoesophageal reconstruction with free jejunal transfer following total pharyngolaryngoesophagectomy in the Shizuoka Cancer Center from 2002 to 2008. Postoperative complications occurred in 48 of 90 (53%) patients. Tracheostomal stenosis (21%), stricture (13%) and small bowel obstruction (9%) were the most common complications. The rate of tracheostomal stenosis and stricture did not correlated with the perioperative radiation therapy. Minor jejunum-esopahageal anastmotic leakage occurred in two patients (2%). Graft loss occurred in one patient (1%). Although free jejunal transfer is a reliable procedure for pharyngoesophageal reconstruction, the rate of postoperative late complications is not small. A long-term follow up study must be carried out.