A New Method of Subcutaneous Placement of Free Jejunal Flaps to Reconstruct a Diversionary Conduit for Swallowing in Complicated Pharyngoesophageal Injury
| Autor: | Yeuh-bih Tang, Jagdeep S. Chana, Hung-Chi Chen, Guan-Ming Feng, Mark Ho-Asjoe, Chau-hsiung Chang |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Epiglottis medicine.medical_specialty Caustics medicine.medical_treatment Free flap Surgical Flaps Esophagus Postoperative Complications Swallowing Burns Chemical medicine Humans Esophageal disease business.industry Middle Aged Plastic Surgery Procedures medicine.disease Surgery Jejunum medicine.anatomical_structure Esophagoplasty Jejunostomy Pharynx Female Deglutition Disorders business Airway Choking |
| Zdroj: | Plastic and Reconstructive Surgery. 112:1528-1533 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/01.prs.0000083377.41505.bb |
| Popis: | Choking is a serious problem in pharyngoesophageal reconstruction, which may occur following tumor ablation of the pharynx or following corrosive injury involving the epiglottis and other parts of the upper airway. To prevent choking and the risk of severe pulmonary complications, patients have to give up oral intake and assume feeding via jejunostomy for the rest of their lives. After reconstruction of the esophagus, eight patients experienced frequent choking and aspiration. With a free jejunal flap, the inlet for food could be separated from the route of the upper airway by a diversion technique. The jejunum segment was transferred microsurgically to reconstruct the cervical esophagus, with its inlet at the buccogingival sulcus. There were no surgical complications related to either the free jejunal flap transfer or the donor site. Postoperatively, patients require re-education of their pattern of swallowing, but after the rehabilitation period all patients reported a satisfactory oral intake through the reconstructed esophagus to the abdomen without choking. There were no episodes of aspiration following reconstruction. With this new method to create a separate food pathway, patients can resume oral intake safely without choking and without permanent jejunostomy. This technique offers a useful solution for patients who suffer from recurrent choking and aspiration following injury or ablation of the pharynx. |
| Databáze: | OpenAIRE |
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