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

[Abstract] [Full Text PDF] （in Japanese / 4154KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 102(9): 647-652, 2001

Feature topic

RECONSTRUCTION OF THE CERVICAL ESOPHAGUS BY INTERPOSITION OF THE TRANSVERSE COLON

1) Department of Surgery II, Oita Medical University, Oita, Japan
2) Department of Otorhinolaryngology, Oita Medical University, Oita, Japan

Tsuyoshi Noguchi1), Yuzo Uchida1), Tsuyoshi Hashimoto1), Shinsuke Wada1), Takeshi Suko2), Masashi Suzuki2)

Currently, the first choice viscus for reconstruction after total pharyngolaryngoesophagectomy is a jejunal interposition. This requires at least one end-to-side anastomosis in the pharyngo-jejunal anastomosis, esophago-jejunal anastomosis, or both due to the small diameter of the jejunum and round shape of the mesenterium. Furthermore, the jejunal graft experiences a spasm when the patient swallows. For such reasons the jejunal free graft is not suitable for swallowing.
On the other hand, the transverse colon graft is more appropriate for reconstruction for the following reasons : it has a straight shape ; end-to-end anastomosis is possible to both the pharynx and esophagus ; and there are postoperative complications due to simple anastomosis of the remaining colon after graft removal. Blood vessel anastomoses, performed using microsurgery techniques, are followed by esophageal reconstructlve anastomoses. Fifteen patients successfully underwent this type of reconstruction in our institution.

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