The Use of Diaphragmatic Pedicle Grafts for Reconstructive Procedures in the Esophagus and Tracheobronchial Tree

The use of well vascularized, denervated grafts of diaphragmatic muscle for repair of injury to the esophagus and tracheobronchial tree is described. The techniques for mobilization of the grafts to different areas of the chest and neck are outlined and illustrated by reference to patients with spontaneous esophageal perforation, bronchopleural fistula, and injury to the posterior tracheal membrane at the thoracic inlet. Diaphragmatic muscle is strong, elastic, well vascularized, and resistant to necrosis, with good regenerative capacity. These attributes make it the ideal material for reconstructive work in the chest and neck.