Dysphagia after an L-shaped reconstruction technique of the free jejunum graft.
Publication year
2010Source
Journal of Plastic, Reconstructive and Aesthetic Surgery, 63, 11, (2010), pp. 1820-4ISSN
Annotation
01 november 2010
Publication type
Article / Letter to editor
Display more detailsDisplay less details
Organization
Surgery
Journal title
Journal of Plastic, Reconstructive and Aesthetic Surgery
Volume
vol. 63
Issue
iss. 11
Page start
p. 1820
Page end
p. 4
Subject
NCEBP 2: Evaluation of complex medical interventionsAbstract
BACKGROUND: The free jejunum graft is a well-established reconstruction technique after total laryngopharyngectomy. However, besides necrosis of the jejunum graft, the two most important complications are pharyngocutaneous fistula formation and dysphagia due to stricture formation. OBJECTIVES: This study aims to develop an L-shaped reconstruction technique of the free jejunum graft to decrease pharyngocutaneous fistula formation and long-term stricture formation after total laryngopharyngectomy. METHODS: An L-shaped side-to-end anastomosis was performed at the proximal end of the jejunum graft in six patients treated for piriform sinus carcinoma. Patient and operation characteristics and follow-up were recorded. RESULTS: A successful jejunum transfer was performed in all six patients. No pharyngocutaneous fistula or stricture formation occurred during a median follow-up of 23 months (range: 18-30 months). Swallowing rehabilitation started at the median 12th postoperative day (range: 5-150 days). Four patients developed dysphagia at a median of 2 months (range: 1-6 months) after oral intake was started. X-barium swallow revealed a redundant pouch of the transferred jejunum graft, which resulted in compression on the jejunum interposition during swallowing. In three patients, an operation was required to resolve these problems. After the revision operation, no dysphagia occurred during a median follow-up of 12 months (range: 7-13 months). CONCLUSIONS: Because of dysphagia complaints in the majority of our patients, we cannot recommend the described technique and should find other means to improve direct postoperative results and long-term quality of life in this difficult-to-treat group of patients.
This item appears in the following Collection(s)
- Academic publications [245263]
- Faculty of Medical Sciences [93208]
Upload full text
Use your RU credentials (u/z-number and password) to log in with SURFconext to upload a file for processing by the repository team.