遊離空腸による下咽頭•頸部食道の再建

概要

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The complications and swallowing functions were studied in eleven patients who had undergone free jejunal autograft reconstruction after total pharyngolaryngectomy and cervical esophagotomy.All patients have had advanced cancers of the hypopharynx or cervical esophagus. Fistulla was complicated in three patients (27%), including one (9%) who died of pneumonia. Death or graft necrosis was not complicated in perioperative period. There was no patient with stenosis.Radiation necrosis of the graft and skin occured six monthes after post-operative 60 Gy irradiation in one patient. Ten patients of 11 regained swallowing function. An oral diet was started between 9 and 50 post-operative days, with an average of 19 days. The duration of a diet was from 20 to 60 minutes (mean : 37 to 40 minutes). Five patients could take a normal diet, while the another five ate gluel or liquid food. The free jejunal graft reconstruction of pharyngoesophagus was highly safe reliability and an advantage in an early recovery of swallowing function, but it had some problems with regard to post-operative irradiation and swallowing.