Retrograde Analysis of Complications of Jejunal Free Flap after Total Pharyngo-Laryngo-Cervical Esophagectomy in Advanced Hypopharyngeal Cancer Treatment

Korean Journal of Head & Neck Oncology 2008;24(1):43-46.
Published online May 30, 2008.

Hyun Jin Min;Dong Woo Hyun;Young Ho Kim;Eun Chang Choi;Kwang Moon Kim;Se Heon Kim

하인두암에서 후두인두 및 경부 식도 전 적출술 후 유리 공장 이식술의 합병증에 대한 후향적 분석

민현진;현동우;김영호;최은창;김광문;김세헌

Abstract

Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngo-cervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

Key Words: Hypopharyngeal cancer, Jejunal free flap, Tubed radial forearm free flap