J Reconstr Microsurg 2008; 24(2): 089-092
DOI: 10.1055/s-2008-1076092
© Thieme Medical Publishers

Curious Complication after Oroesophageal Reconstruction with Free Jejunal Flap: Intussusception-like Deformity of Transferred Jejunum

Shunsuke Sakakibara1 , Shinya Tahara1 , Kazunobu Hashikawa1 , Ken-ichi Nibu2
  • 1Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
  • 2Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Further Information

Publication History

Publication Date:
25 April 2008 (online)

ABSTRACT

Regions of oropharyngeal cancer, hypopharyngeal cancer, and cervical esophageal cancer in a 70-year-old man were surgically resected and reconstructed with a free jejunal flap. Postoperatively the patient showed severe dysphagia and a chimneylike protrusion in the oral cavity. In a second operation, a dorsal, longitudinal incision for phimosis was made to release the stenosis; however, the dysphagia persisted, and peristalis seemed to interfere with deglutition. Here, we discuss the cause of the dysphagia, a complication of total reconstruction of oroesophageal defects with a single free jejunal flap, and the procedures of reconstruction.

REFERENCES

  • 1 Giovanoli P, Frey M, Schmid S, Flury R. Free jejunum transfers for functional reconstruction after tumour resections in the oral cavity and the pharynx: changes of morphology and function.  Microsurgery. 1996;  17 535-544
  • 2 Cordeiro P G, Shah K, Santamaria E et al.. Barium swallows after free jejunal transfer: should they be performed routinely?.  Plast Reconstr Surg. 1999;  103 1167-1175
  • 3 Hsiao H T, Leu Y S, Lin C C. Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.  Ann Plast Surg. 2002;  49 612-616
  • 4 Hsiao H T, Leu Y S, Chang S H, Lee J T. Swallowing function in patients who underwent hemiglossectomy: comparison of primary closure and free radial forearm flap reconstruction with videofluoroscopy.  Ann Plast Surg. 2003;  50 450-455
  • 5 Lewin J S, Barringer D A, May A H et al.. Functional outcomes after circumferential pharyngoesophageal reconstruction.  Laryngoscope. 2005;  115 1266-1271
  • 6 Ozkan O, Chen H C, Cigna E et al.. Intussusception of a transferred jejunal flap in cervical esophagus reconstruction.  Ann Plast Surg. 2005;  55 327-329
  • 7 Hendrix T R. Coordination of peristalsis in pharynx and esophagus.  Dysphagia. 1993;  8 74-78
  • 8 Reidenbach M M. Anatomical considerations of closure of the laryngeal vestibule during swallowing.  Eur Arch Otorhinolaryngol. 1997;  254 410-412

Shunsuke SakakibaraM.D. Ph.D. 

Department of Plastic Surgery, Kobe University Graduate School of Medicine

7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan