Esophagus reconstruction with free jejunal transfer

Following pharyngolaryngectomy, reconstruction is one of the most challenging surgical procedures. Here we review our own experiences using a microvascularly transferred free jejunal graft. This method was performed in 22 patients (19 male and 3 female, aged 40–63 years). Seven patients underwent neoadjuvant chemo‐radiotherapy. Eighteen patients had immediate reconstruction after pharyngolaryngectomy, and 4 patients had delayed reconstruction because of complications from previous surgeries (2 stenoses, and 2 recurrent cancers). The duration of surgery ranged from 5–9 h (mean, 6.3 h), and the ischemic time of the graft was 70–125 min (mean, 88 min). This method has several advantages: it is a one‐step operation; the graft is covered by self‐cleaning mucosa; the development of fistulas and stenoses is rare; and the technique provides good swallowing. Owing to its good blood supply, this reconstructive method can also be used in previously irradiated areas. © 2006 Wiley‐Liss, Inc. Microsurgery 26: 73–77, 2006.