|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
| FIG. 27-04. The esophageal remnant is held with clamps at the base of the neck.
A 60-year-old man underwent a laryngopharyngectomy and partial esophagectomy and had reconstruction with local flap coverage. Subsequently, he developed a chronic cervical fistula. Six months after his prior procedure, the patient underwent a free jejunal transfer to reconstruct the cervical esophagus. Microanastomoses were performed again between the jejunal artery and the superior thyroid artery using 9-0 nylon suture. The venous anastomosis was end-to-end to the external jugular vein. A deltopectoral flap was simultaneously performed to cover the transplanted bowel. A follow-up contrast swallow on the tenth postoperative day showed no evidence of fistulae and the patient was again given liquids and discharged from the hospital. The deltopectoral flap was revised on the twenty-first postoperative day with no evidence of breakdown or loss of the jejunal segment.
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