J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3351KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 100(9): 557-561, 1999

Feature topic

APPLICATION OF MICROVASCULAR SURGERY IN RECONSTRUCTIVE DIGESTIVE TRACT SURGERY

1) Department of Plastic and Reconstructive Surgery, Hokkaido University School of Medicine, Sapporo, Japan
2) The Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan
3) The First Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan
4) The Clinic of Plastic and Reconstructive Surgery, Soshundo Hospital, Sapporo, Japan

Yuhei Yamamoto1), Satoru Sasaki1), Hiroshi Furukawa1), Hiroharu Igawa1), Shunichi Okushiba2), Koichi Ohno2), Hiroyuki Furukawa 3), Akihiro Kishida3), Takashi Ohmura3), Masaru Nomura3), Kunihiko Nohira4)

In our institutes, microvascular surgery has been effectively used in reconstructive digestive tract surgery, including esophageal reconstruction and hepatic arterial reconstruction. Free jejunal transfer combined with a gastric pedicle or microvascularly augmented elongated gastric pedicle has been utilized for total esophageal reconstruction. A microvascularly augmented jejunal pedicle or colonic pedicle has been applied in thoracic esophageal reconstructive cases with gastrectomy. Moreover, microvascular surgery has been performed in the reconstruction of the hepatic arterial system in the surgical treatment of pancreatic or bile duct cancer and living related-donor liver transplantation. Some pitfalls in selection of the recipient vessels and handling the intraperitoneal vessels for microvascular anastomosis are also described. Although microvascular surgery has been carried out by plastic and reconstructive surgeons in a team surgical approach, revisions in the medical educational system to create a new-type of surgeon with practical skills and clinical experience in both digestive tract and microvascular surgery will be required in future.

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