T-shaped re-anastomosis of graft for outlet obstruction after free jejunal graft

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
Y TabiraM Kawasuji

Abstract

We experienced three patients with persistent outlet obstruction after free jejunal graft and performed T-shaped re-anastomosis for relief of this symptom. Two patients underwent a laryngopharyngectomy for hypopharyngeal cancer and the other patient underwent a laryngopharyngectomy and total esophagectomy for concurrent hypopharyngeal cancer and esophageal cancer. We reconstructed alimentary conduit by a free jejunal reconstruction without using surgical microscopes. In brief, a graft vein and the internal jugular vein were anastomosed and a graft artery and the carotid artery were anastomosed. Then, the anastomosis of pharyngojejunostomy was carried out in a side-to- end fashion, followed by an end-to- end jejunesophagostomy. In a T-shaped re-anastomosis, the flexure of the transplanted jejunum was separated by GIA (US Surgical Corporation, Norwalk, CT, USA). In cases where the efferent part was redundant, the proximal or distal site was resected and straightened in order to avoid outlet stasis. After this, the end-to-side anastomosis between the efferent part and the bottom of proximal horizontal portion of the graft was performed by CDH (Ethicon, Somerville, NJ, USA) or Olsen's one layer method. These three patients received...Continue Reading

References

Oct 1, 1987·American Journal of Surgery·J J ColemanM J Jurkiewicz
Jun 1, 1986·Gastroenterology·P KerlinD Theile
Apr 1, 1971·Plastic and Reconstructive Surgery·P W BlackP G Arnold
Mar 1, 1984·The Japanese Journal of Surgery·T TanakaT Sakabe
Nov 1, 1981·The Laryngoscope·J L GluckmanD A Shumrick
May 1, 1980·American Journal of Surgery·T M SasakiR M Vetto

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Citations

Nov 3, 2009·Surgery Today·Masahide IkeguchiShun-ichi Tsujitani
Dec 9, 2009·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·S KeereweerJ H W De Wilt

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