Free Jejunal Graft Repair after PharyngoLaryngo-Esophagectomy-Risk Factor Analysis for Postoperative Dysphagia
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概要
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Purpose: Reconstruction with free jejunal graft (FJG) has been widely accepted for patients undergone pharyngo-cervical esophageal resection. Those patients often suffer variety of complications regarding postoperative peros function. We investigated risk factors especially focused on the development of dysphagia after FJG reconstruction. Methods: A retrospective analysis was conducted using clinical chart review of 30 consecutive patients who underwent reconstruction with a FJG after pharyngo-laryngoesophagectomy from 1995 to 2010. Mortality, morbidity, and postoperative dysphagia were investigated. Dysphagia was defi ned when the patients required enteral nutrition until later than 1 month postoperatively without any other complications, including anastomotic leakage, anastomotic stricture, FJG ischemic necrosis, and hospital death. Data on potential clinical factors were extracted and the relation of these variables to postoperative dysphagia was examined by univariate and multivariate analysis. Results: There was one patient with hospital death over total 30 patients who deceased due to fatal postoperative bleeding from arterial anastomosis of FJG. Postoperative complications occurred in 14 patients (46.7%) those included respiratory complication in 5, anastomotic leakage 3, FJG ischemic necrosis 2, paralytic ileus 2, ischemic change of tracheostomy 2, anastomotic stricture 1 and dysphagia 9. Dysphagia was the most frequent in this series. Multivariate analysis demonstrated induction radiation (≥60 Gy) was independently signifi cant factors for postoperative dysphagia. Conclusion: FJG reconstruction may be safe and functionally satisfactory surgical option after pharyngo-laryngo-esophagectomy. Postoperative dysphagia may be induced prior radiation therapy.
- Annals of Thoracic and Cardiovascular Surgery 編集委員会の論文
著者
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Yamashita Yuichi
Department Of Gastroenterogical Surgery Fukuoka University Hospital And School Of Medicine
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Shiraishi Takeshi
Department Of Electrical & Electronic Engineering Ritsumeikan University
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Hoshino Seiichiro
Department Of Gastroenterological Surgery Fukuoka University School Of Medicine
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Nakagawa Takashi
Department Of Biological Science And Technology Faculty Of Engineering The University Of Tokushima
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Sueta Takayuki
Department Of Otorhinolaryngology Faculty Of Medicine Fukuoka University
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Yamana Ippei
Department Of Gastroenterological Surgery Faculty Of Medicine Fukuoka University
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Shiraishi Takeshi
Department of Thoracic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
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Shiroshita Toyoo
Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
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Yamashita Yuichi
Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
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Hoshino Seiichiro
Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
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Yamana Ippei
Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
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Sueta Takayuki
Department of otolaryngology, Fukuoka University School of Medicine, Fukuoka, Japan
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