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Free vascularized jejunum interposition for pharyngoesophageal reconstruction after total laryngopharyngectomy
Authors:J. J. HOORWEG  J. A. RAUWERDA  G. A. CROLL  A. J. C. MACKAAY  E. K. J. RISSE  N. DE VRIES  R. M. TIWARI
Abstract:The records of 28 patients who underwent free jejunal graft reconstruction after resection for cancer involving the pharynx were analysed. Seven patients had a T3 carcinoma, 15 patients T4 and six patients recurrence after laryngectomy. Ten patients had received radiotherapy in the past. Post-operatively, 15 patients (54%) had complications and two patients (7%) died. No significant difference was observed in the complication rate between the group that received radiotherapy in the past and those who did not. Nineteen patients received post-operative radiotherapy. Nine patients had no radiotherapy on the basis of complete resection or because of serious complications. For the whole group the 2-year recurrence free period and survival were 42% and 51% respectively. The postoperative radiotherapy group had a significantly better survival (73%) and recurrence free period (63%) than the group without post-operative radiotherapy (0%). Thus, post-operative radiotherapy seems indicated irrespective of resection margins.
Keywords:jejunal free flap interposition  laryngo-pharyngeal carcinoma  post-operative therapy  survival and recurrence free period  complications
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