A revised method for pharyngoesophageal reconstruction using free jejunal transfer

Area of Science:

• Surgical Reconstruction
• Gastrointestinal Surgery
• Otolaryngology

Background:

• Pharyngoesophageal reconstruction using free jejunal transfer is a standard procedure.
• Achieving optimal functional results remains a challenge, with risks of stricture and fistula formation.

Purpose of the Study:

• To present a devised surgical method for pharyngoesophageal reconstruction using free jejunal transfer.
• To improve functional outcomes and minimize complications such as delayed stricture and fistula formation.

Main Methods:

• A modified jejunoesophageal anastomosis involving longitudinal incisions at the esophageal stump corners, creating a Z-plasty-like effect.
• An end-to-end pharyngojejunal anastomosis with a specific longitudinal incision on the jejunal graft to manage tension and prevent anterior fistula formation.

Main Results:

• The procedure was performed on twenty patients with satisfactory postoperative deglutition.
• No cases of jejunal redundancy, constriction, or fistula formation were reported.
• The method demonstrated stable and effective reconstruction for pharyngoesophageal defects.

Conclusions:

• The devised surgical technique offers a simple and effective method for pharyngoesophageal reconstruction.
• This approach enhances functional results and reduces the incidence of common complications associated with free jejunal transfer.
• The method is broadly applicable to various pharyngoesophageal defects, ensuring reliable outcomes.