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Mesenteric flap in free jejunal transfers: a versatile technique for head and neck reconstruction
Y Yamamoto1, K Nohira, Y Shintomi
1Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo, Japan.
Background:
The technique of free jejunal transfers has been widely used for pharyngoesophageal reconstruction. However, secondary infectious and fistulous complications may develop in extensive and preoperatively high-dose irradiated cases.
Methods:
A generous jejunomesenteric composite graft was harvested and the mesenterium was effectively applied for head and neck reconstruction.
Results:
The mesenteric flap connected with the revascularized jejunum was used as means for obliterating dead space in the head and neck region, as a cover for the cover for the cervical vessels, as a vascularized bolstering for the vascular and enteral anastomoses, or as a vascularized bed for skin grafting when the skin flaps are deficient. Only one small fistula occurred in 10 patients who underwent the mesenteric flap.
Conclusions:
This versatile technique is expected to reduce the incidence of postoperative complications in pharyngoesophageal reconstruction using free jejunal transfers.