Seventy-four patients who had undergone free jejunal autografts for head and neck reconstruction were reviewed to determine what might be necessary to increase the success rate of this technique. The success rate of these free jejunal autografts was 96 percent and as a whole 88 percent of these patients could resume an oral diet eighteen days after operation on average.
Patients who had developed a fistula or total necrosis of the grafted jejunum frequently showed hyperglycemia or tachycardia immediately after operation. Endothelial damage to the vessels and/or impairment in peripheral circulation were thought to be one of the causes of these complications, suggesting that it is advisable to strictly monitor blood sugar and heart rate after such operations.
Patients whose distal anastomoses had been irradiated postoperatively frequently showed stricture at the distal anastomoses. It was thought to be due to the edema during irradiation and cicatricious stenosis after irradiation, suggesting that these patients should undergo dilatation frequently.
