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DOI: 10.1055/s-2005-862772
Double Vascular Pedicled Free Jejunum Transfer for Total Esophageal Reconstruction
Publikationsverlauf
Publikationsdatum:
26. Januar 2005 (online)
ABSTRACT
A double vascular pedicled free jejunum was transferred in two patients with complete esophageal defect. When the stomach and colon, which are usually employed for esophageal reconstruction, cannot be used due to previous operations or for other reasons, the jejunum is the next alternative. However, pedicled jejunal transposition is limited in length and may not reach a suitable level over the lower cervical esophagus, even if the distal portion is supercharged. Under such circumstances, a long jejunal segment with two vascular pedicles can be transferred as a free flap and used to reconstruct the whole esophagus in one stage. The paper describes two cases and discusses the advantages of double vascular pedicled free jejunum transfer.
KEYWORDS
Dual pedicle - free jejunal flap - esophageal reconstruction
REFERENCES
- 1 Appignani A, Lauro V, Prestipino M, Centonze N, Domini R. Intestinal bypass of the oesophagus: 117 patients in 28 years. Pediatr Surg Int. 2000; 16 326-328
- 2 Maier A, Pinter H, Tomaselli F et al.. Retrosternal pedicled jejunum interposition: an alternative for reconstruction after total esophago-gastrectomy. Eur J Cardiothorac Surg. 2002; 22 661-665
- 3 Longmire W P. A modification of the Roux technique for ante-thoracic esophageal reconstruction. Surgery. 1947; 22 94-100
- 4 Hirabayashi S, Miyata M, Shoji M, Shibusawa H. Reconstruction of the thoracic esophagus, with extended jejunum used as a substitute, with the aid of microvascular anastomosis. Surgery. 1993; 113 515-519
- 5 Chana J S, Chen H C, Sharma R, Gedebou T M, Feng G M. Microsurgical reconstruction of the esophagus using supercharged pedicled jejunum flaps: special indications and pitfalls. Plast Reconstr Surg. 2002; 110 742-748 , discussion 749-750
- 6 Germain M A, Hartl D M, Boutin P, Marandas P, Luboinski B. Total esophagoplasty using a doubly vascularized free jejunal transplant: a last resort in two patients. Plast Reconstr Surg. 2003; 111 801-804
- 7 Raffensperger J G, Luck S R, Reynolds M, Schwartz D. Intestinal bypass of the esophagus. J Pediatr Surg. 1996; 31 38-46
- 8 DeMeester T R, Johansson K E, Franze I et al.. Indications, surgical technique, and long-term functional results of colon interposition or bypass. Ann Surg. 1988; 208 460-474
- 9 Lundell L, Olbe L. Colonic interposition for reconstruction after resection of cancer in the esophagus and gastroesophageal junction. Eur J Surg. 1991; 157 189-192
- 10 Ahmad S A, Sylvester K G, Hebra A et al.. Esophageal replacement using the colon: is it a good choice?. J Pediatr Surg. 1996; 31 1026-1030
- 11 Ring W S, Varco R L, L'Heureux P R, Foker J E. Esophageal replacement with jejunum in children: an 18 to 33 year follow-up. J Thorac Cardiovasc Surg. 1982; 83 918-927
- 12 Saeki M, Tsuchida Y, Ogata T, Nakano M, Akiyama H. Long-term results of jejunal replacement of the esophagus. J Pediatr Surg. 1988; 23 483-489
- 13 Cusick E L, Batchelor A A, Spicer R D. Development of a technique for jejunal interposition in long-gap esophageal atresia. J Pediatr Surg. 1993; 28 990-994
- 14 Matsubara T, Ueda M, Nakajima T, Kamata S, Kawabata K. Elongated stomach roll with vascular microanastomosis for reconstruction of the esophagus after pharyngolaryngoesophagectomy. J Am Coll Surg. 1995; 180 613-615
- 15 Kawai K I, Kakibuchi M, Sakagami M et al.. Supercharged gastric tube pull-up procedure for total esophageal reconstruction. Ann Plast Surg. 2001; 47 390-393
- 16 Inoue Y, Tai Y, Fujita H et al.. A retrospective study of 66 esophageal reconstructions using microvascular anastomoses: problems and our methods for atypical cases. Plast Reconstr Surg. 1994; 94 277-284
- 17 Shaw W W. Microvascular free flap breast reconstruction. Clin Plast Surg. 1984; 11 333-341
- 18 Dupin C L, Allen R J, Glass C A, Bunch R. The internal mammary artery and vein as a recipient site for free-flap breast reconstruction: a report of 110 consecutive cases. Plast Reconstr Surg. 1996; 98 685-689
- 19 Schwabegger A H, Bodner G, Rieger M, Jaschke W R, Ninkovic M M. Internal mammary vessels as a model for power Doppler imaging of recipient vessels in microsurgery. Plast Reconstr Surg. 1999; 104 1656-1665
Akihiko TakushimaM.D.
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University
6-20-2, Shinkawa, Mitaka-shi
Tokyo, 181-8611, Japan