FIG. 27-15

FIG. 27-16. Because of the scarring produced by previous reconstruction, the deep vascular structures are isolated to ascertain if there are suitable recipient vessels available.

FIG. 27-17. Lateral view. The jejunal segment has been transplanted to the neck and revascularized by the superior thyroidal artery and external jugular vein.

FIG. 27-18. Anterior view. The proximal laryngeal-jejunal anastomosis must be made deep in the neck at the base of the tongue, posterior wall closure. Single layer of sutures (see text).

FIG. 27-19. Anterior wall closure.

FIG. 27-20. At 10 days postoperatively, after contrast studies, the patient is permitted liquids by mouth.

References

1. Seidenberg, B., Rosenak, S.S., Hurwitt, E.S., and Som, M.L.: Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment. Ann. Surg. 149:162, 1959.

2. Buncke, H.J., and Schulz, W.P.: Experimental digital amputation and replantation. Plast. Reconstr. Surg. 36:62, 1965.

3. Daniel, R.K., and Taylor, G.I: Distant transfer of an island flap by microvascular anastomoses. Plast. Reconstr. Surg. 52:111, 1973.

4. O'Brien, B.M., MacLeod, A.M., Hayhurst, J.W., and Morrison, W.A.: Successful transfer of a large island flap from the groin to the foot by microvascular anastomoses. Plast. Reconstr. Surg. 52:271, 1973.

5. Gluckman, J.L., McCafferty, G.J., Black, R.I., et al.: Complications associated with free jejunal graft. Reconstruction of the pharyngoesophagus. A multi-institutional experience with 52 cases. Head Neck Slxrg. 7:200, 1985.

6. Heimlich, H.J.: Reversed gastric tube esophagoplasty for failure of colon, jejunum and prosthetic interpositions. Ann. Surg. 182:154, 1975.

7. Silver, C.E.: Gastric pull-up operation for replacement of the cervical portion of the esophagus. Surg. Gynecol. Obstet. 142:243, 1976.

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