J.Jpn. Surg. Soc.. 109(5): 249-255, 2008

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Feature topic

CURRENT BEST SURGICAL PROCEDURE FOR RECONSTRUCTION AFTER CERVICAL ESOPHAGECTOMY

Currently, chemoradiotherapy offers the possibility of larynx-preserving treatment. Therefore, the surgical procedure for reconstruction involves not only reconstruction of the alimentary tract but also needs to be selected considering postoperative swallowing function. In larynx-preserving surgery, it is necessary to pay attention to the elevation of the larynx and the prevention of reflux, considering the narrow space of recipient laryngeal space. Free jejunal interposition is the best method for cervical esophageal reconstruction and the free jejunum plus gastric roll or ileocolic reconstruction technique is appropriate for total esophageal substitution. In patients undergoing combined resection of the larynx, there is no need to consider aspiration, but it is important for postoperative quality of life to prevent reflux. Therefore, the free jejunum plus gastric roll or ileocolic reconstruction technique is used for total esophageal substitution. For cervical esophageal reconstruction, the free jejunal graft is slightly better than the free colon graft in terms of simplicity and lower rates of postoperative infection.

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