Esophagoplasty with hybrid-supercharged jejunum / Nyelocsopótlás hybrid, supercharged jejunummal

Introduction: In this case report an esophageal resection due to cancer was performed with a primary left colonic replacement, as the stomach was resected previously. Due to graft necrosis, the necrotized section of the colon was removed. One year later a long jejunal segment with a combined blood supply was used for secondary reconstruction. Even after the ligation of three straight branches, the Roux loop was not long enough to reach up to the neck, however the division of the arcade between the 2nd and 3rd straight branches lengthened it satisfyingly. Blood supply to the region of the farthest branch was provided from the internal mammary artery and venous drainage was provided by a saphenous vein graft to the external jugular vein. The continuity of the jejunal graft was preserved. The patient recovered uneventfully. If neither the stomach nor the colon routinely used for esophageal replacement are available due to anatomical reasons, previous surgeries, or complications, jejunal replacement can be the last resort. Jejunum is only suitable for safe esophageal replacement by either free transplantation or by supercharging. The procedure when a combined blood supply is provided for the jejunal replacement was named the hybrid-supercharged method.

Free jejunal segment transplantation to reconstruct the esophageal defect caused by tumor resection and fol-low-up observation by endoscopy / 中华显微外科杂志

Objective To investigate the method and curative effect of the posterior cervical esophageal de-fect after the reconstruction of lower pharyngeal carcinoma by dissociation of the lower pharyngeal carcinoma. Meth-ods From August,2015 to June,2017, we used the jejunum segment. to reconstruct five patients' esophageal defect in the neck segment enlarged after the enlargement of the hypopharyngeal carcinoma. The length of the jejunum was 8.0 -15.0 cm, We used microvascular stapling to anastomosis vein in surgery. The morphological and functional changes of the graft tube were observed by endoscopic follow-up. Results All 5 patients were discharged from the hospital with an average of 12 days in hospital.The mean time of heat ischemia was 8 minutes,and the average oper-ation time was 5.2 hours. After endoscopic follow-up for 12 months, no stricture or anastomotic leakage occurred in the transplanted bowel, and the intestine moves downward autonomously, the morphological and functional remodeling of transplanted intestinal tract was observed. Conclusion Free jejunal reconstruction of hypopharyngeal carcinoma resection for cervical esophageal is a safe method with a good outcome in morphological and functional remodeling.It' s one of the ideal methods to reconstruct cervical esophageal defect.