[Reconstruction of the esophagus and hypopharynx by free jejunum interposition]

Beside conventional procedures the hypopharyngeal and esophageal reconstruction using a free jejunum-transfer represents an additional method for primary reconstruction of the hypopharynx and esophagus. Out of 48 free jejunum-transfers 16 were used for bridging an hypopharyngeal or esophageal defect, 32 as a patch for reconstruction of the oral cavity. In 7 patients a hypopharynx carcinoma was resected, in 6 cases the cervical esophagus was infiltrated by carcinoma. 3 patients suffered from an esophageal stenosis caused by corrosion after acid ingestion. 11 free grafts healed without any complications. In 2 cases the jejunum was removed because of necrosis. In 3 cases fistulation from the lower anastomosis was observed. Free, microvascular jejunum-transfer using physiological graft material not only seems to be advantageous for tolerance to radiation but is also a one step surgical procedure.