eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Tissue Transfer, Jejunum: Follow-up

Author: Tamer A Ghanem, MD, PhD, Microvascular/Reconstructive Fellow, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University
Coauthor(s): Stephen M Weber, MD, PhD, Fellow in Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Division of Plastic and Reconstructive Surgery, University of Michigan; Mark K Wax, MD, Professor and Program Director, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University; Service Chief, Department of Surgery, Section of Otolaryngology, Veterans Affairs Medical Center
Contributor Information and Disclosures

Updated: May 27, 2008

Outcome and Prognosis

The free jejunum flap has gained popularity as the success of the microvascular technique has increased. With flap survival and successful reconstruction rates as high as 97.6% and the patient mortality rate less than 5%, this technique has proven both effective and reliable.

Resumption of oral alimentation is observed in 60-90% of patients within 10-16 days postoperatively.

Future and Controversies

Although the free jejunum effectively reconstructs the lost portion of the upper aerodigestive tract with a mucosal lined conduit, many problems still exist. Current techniques of tracheal puncture provide acceptable speech, but one of the most significant problems with jejunal reconstruction is the "wet" and relatively poor quality of voice. As experience with microsurgical technique increases, morbidity from the operation may decrease, and functional outcomes will naturally improve.

 


More on Tissue Transfer, Jejunum

Overview: Tissue Transfer, Jejunum
Workup: Tissue Transfer, Jejunum
Treatment: Tissue Transfer, Jejunum
Follow-up: Tissue Transfer, Jejunum
Multimedia: Tissue Transfer, Jejunum
References
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References

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  2. Seidenberg MD, Rosenak SS, Hurwitt ES, Som ML. Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment. Ann Surg. Feb 1959;149(2):162-71. [Medline].

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Further Reading

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Keywords

free intestinal transfer, free jejunum transfer, jejunum free tissue transfer, jejunal free autograft, cancer of the hypopharynx, cancer of the cervical esophagus, pharyngoesophageal resection, pharyngoesophageal cancer, jejunal free flap reconstruction, speech function, swallowing function

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Contributor Information and Disclosures

Author

Tamer A Ghanem, MD, PhD, Microvascular/Reconstructive Fellow, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University
Tamer A Ghanem, MD, PhD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and Triological Society
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen M Weber, MD, PhD, Fellow in Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Division of Plastic and Reconstructive Surgery, University of Michigan
Stephen M Weber, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Phi Beta Kappa, and Triological Society
Disclosure: Nothing to disclose.

Mark K Wax, MD, Professor and Program Director, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University; Service Chief, Department of Surgery, Section of Otolaryngology, Veterans Affairs Medical Center
Mark K Wax, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Surgeons, American Rhinologic Society, American Society for Head and Neck Surgery, American Society for Laser Medicine and Surgery, Canadian Academy of Facial Plastic and Reconstructive Surgery, North American Skull Base Society, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Terance (Terry) Ted Tsue, MD, Vice-Chairman for Administrative Affairs, Professor, Residency Program Director, Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine
Terance (Terry) Ted Tsue, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, Association for Research in Otolaryngology, Johns Hopkins Medical and Surgical Association, Missouri State Medical Association, Phi Beta Kappa, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David W Stepnick, MD, Associate Professor, Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland Case Medical Center
David W Stepnick, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Advanced Headache Intervention Consulting fee Consulting; Covidien Corp Consulting fee Consulting

 
 
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