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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546

Abstract

GALVAO, Mário Sergio Lomba et al. Pharyngoesophageal reconstruction using free jejunal flap following neck pharyngolaryngoesophagectomy. Rev. Col. Bras. Cir. [online]. 2002, vol.29, n.6, pp.353-358. ISSN 0100-6991.  http://dx.doi.org/10.1590/S0100-69912002000600009.

OBJECTIVE: The present study describes the results at the Instituto Nacional de Câncer (Rio de Janeiro-BRAZIL) in reconstruction of cervical esophagus using jejunal interpositional flap. Advantages, disadvantages and possible complications are discussed. METHOD: Seven patients with Iocally advanced carcinoma of the Iarynx and thyroid underwent pharyngoesophageal reconstruction using free jejunal interpositional flap after pharyngolaryngectomy-esophagectomy from december/1 998 through march/2001 at Instituto Nacional de Cancer. There were five men and two women with mean age of 54,1 years old (39-66 years). Three patients underwent immediate esophageal reconstruction. In four cases, the reconstructions were performed under delayed basis (in mean, after 10,5 months). RESULTS: There were no flap failures or perioperative deaths. The most frequent complication was wound infection (57,1%). Salivary fistula occured in two cases (28,5%) and required secundary revision. Other complications were stenosis (14,1%) and hypoparathyroidism (28,5%).There were no abdominal complications. Four out of seven patients presented recurrent disease in a mean time of 8,5 months (3-13 months). Five patients (71%) acquired a satisfactory swallow function after surgery. CONCLUSION: The cases here presented, suggest that free jejunal flap is a safe procedure with high success rates for high digestive tract reabilitation, with few complications.

Keywords : Jejunal free flap; Cervical esophagectomy; Pharyngoesophagus; Pharyngoesophageal reconstruction; Pharyngoesphageal resection.

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