Free jejunal transfer for pharyngo-esophageal reconstruction

Area of Science:

• Surgical Oncology
• Gastroenterology
• Reconstructive Surgery

Background:

• Pharyngeal mucosal defects are common after head and neck cancer surgery.
• Previous studies explored various tissues for reconstruction, including jejunum, colon, and ileum.
• Microsurgical techniques have advanced free tissue transfer success rates.

Purpose of the Study:

• To evaluate the efficacy and safety of free interposing iso-peristaltic jejunal loop transfer.
• To assess complication rates and functional recovery after ablative cancer surgery.
• To analyze early functional and social restoration in patients undergoing this procedure.

Main Methods:

• Free interposing iso-peristaltic jejunal loop transfer was performed in 30 patients.
• The procedure was used to bridge cervical esophagus defects following surgery for advanced hypopharyngeal, laryngeal, and cervical esophageal cancer.
• Complication rates, hospital stay, and swallowing times were recorded and analyzed.

Main Results:

• The major complication rate was 13% (4/30), including flap failure.
• The minor complication rate was 36% (11/30), with 2 cases of postoperative hypothyroidism.
• No intra-abdominal hemorrhage or peri-operative mortality was observed. Average hospital stay was 15 days, with a median swallowing time of 10 days.

Conclusions:

• Free interposing iso-peristaltic jejunal loop transfer is a viable option for pharyngeal reconstruction after cancer surgery.
• The technique demonstrates acceptable complication rates and facilitates early functional and social restoration.
• Further analysis of complication rates and success in functional restoration is warranted.