Reconstructive surgery of the cervical esophagus

Area of Science:

• Surgical Reconstruction
• Gastrointestinal Surgery
• Otolaryngology

Background:

• Pharyngoesophageal reconstruction is essential for restoring function after cervical esophagus removal.
• Current methods include skin grafts, skin flaps, and pedicled or free grafts of stomach or colon.
• Free revascularized jejunal grafts represent an alternative reconstructive approach.

Observation:

• This study details four primary methods of pharyngoesophageal reconstruction.
• Emphasis is placed on free revascularized jejunal grafts, with 55 cases performed.
• The study compares the efficacy and outcomes of different reconstructive techniques.

Findings:

• Free revascularized jejunal grafts achieved a 90% transfer reliability with a 5% perioperative mortality.
• The free jejunal graft procedure demonstrated lower morbidity and mortality compared to esophagogastric anastomosis, colon interposition, and deltopectoral skin flaps.
• Six graft failures were noted in the series of 55 reconstructions.

Implications:

• Free revascularized jejunal grafting is presented as a preferred method for cervical esophageal reconstruction.
• This technique offers a satisfactory and straightforward approach with favorable outcomes.
• The findings suggest a potential shift towards free jejunal grafts as the method of choice in relevant surgical scenarios.