ESOPHAGEAL RECONSTRUCTION BY VASCULARIZED FREE OR PEDICLED JEJU- NAL GRAFT: A REPORT OF 29 CASES / 解放军医学杂志

ABSTRACT

A series of 29 cases of esophageal stenosis or obstruction caused by chemical burn or malignancy in the cervical or upper thoracic segment were treated by resection, and its continuity was re-established by a vascularized free or pedicled jejunal graft. It was successful in 28 cases, with only one failure. The age of these cases ranged from 4 to 65 years old. Among them, 4 children were between 4 and 6. Sixteen cases of pedicled jejunal grafts had their vessels anastomosed to cervical vessels at the upper end. The lengths of the grafts varied from 40 to 60 cm. In the 13 free jejunal grafts, jejunal blood vessels were anastomosed to the right gastroepiploic vessels and cervical vessels at the lower and upper ends, respectively, to re-establish circulation for long jejunal segments, while for the short jejunal grafts anastomosis was made to the cervical vessels only. The vascularized jejunal patch graft is an effective measure for repairing anastomotic fistula or localized wall defect. A regime of monitoring blood circulation of the jejunal transplant is described.