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Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy
dc.contributor.authorKubo, Tateki
dc.contributor.authorKurita, Tomoyuki
dc.contributor.authorTashima, Hiroki
dc.contributor.authorSeike, Shien
dc.contributor.authorFujii, Takashi
dc.contributor.authorYano, Masahiko
dc.contributor.authorYamasaki, Makoto
dc.contributor.authorDoki, Yuichiro
dc.contributor.authorHosokawa, Ko
dc.date.accessioned2018-12-06T17:37:16Z
dc.date.available2020-01-06T16:41:00Zen
dc.date.issued2018-11
dc.identifier.citationKubo, Tateki; Kurita, Tomoyuki; Tashima, Hiroki; Seike, Shien; Fujii, Takashi; Yano, Masahiko; Yamasaki, Makoto; Doki, Yuichiro; Hosokawa, Ko (2018). "Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy." Microsurgery 38(8): 852-859.
dc.identifier.issn0738-1085
dc.identifier.issn1098-2752
dc.identifier.urihttps://hdl.handle.net/2027.42/146618
dc.description.abstractBackgroundWhen pharyngoesophagectomy is performed in conjunction with anterior mediastinal tracheostomy, reconstructing both the trachea and alimentary tract is extremely difficult. We developed a novel 1‐stage reconstructive procedure using a single free jejunal flap containing multiple vascular pedicles to decrease postoperative morbidity and mortality. Free jejunal flap transfer with multiple vascular pedicles could offer a viable option for reducing associated life‐threatening complications.MethodsWe performed a retrospective review of 34 patients who underwent free jejunal flap transfer with multiple vascular pedicles in anterior mediastinal tracheostomy and pharyngoesophagectomy due to lesions involving both the airway and esophagus. In all cases, 1‐stage reconstruction of the digestive tract and trachea was performed. Technical details and outcomes were analyzed.ResultsAll 34 jejunal flaps (100%) survived. Major morbidity classified as Clavien–Dindo grades III and IV occurred in 10 (29.4%) and 0 (0%) patients, respectively during hospitalization. With regard to common complications, anastomotic leakage from transferred jejunal flaps and surgical site infections occurred in 0 (0%) and 7 (20.6%) patients, respectively. Five (14.7%) patients experienced tracheal stoma dehiscence. Donor site morbidity was observed in 2 (5.9%) patients. The overall in‐hospital mortality rate was 2.9%.ConclusionsOur 1‐stage reconstruction procedure achieved low morbidity and low mortality rates following anterior mediastinal tracheostomy and pharyngoesophagectomy. Only 1 jejunal flap transfer is needed to simultaneously reconstruct the trachea and alimentary tract in a safe and reliable manner with this procedure.
dc.publisherJohn Wiley & Sons, Inc.
dc.titleFree jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy
dc.typeArticleen_US
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelNursing
dc.subject.hlbsecondlevelSurgery and Anesthesiology
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/146618/1/micr30359_am.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/146618/2/micr30359.pdf
dc.identifier.doi10.1002/micr.30359
dc.identifier.sourceMicrosurgery
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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