In the 9 years from 1988 to 1996, a hundred and sixty-two patients (Surgery 81, ENT 81) underwent hypopharynx, cervical and thoracic esophageal reconstruction using microvascular anastomoses by our team (Thoracic Surgery, ENT and Head and Neck Surgery and Plastic Surgery). This series comprises 128 patients with reconstructions using a free jejunal transfer, and 34 patients with additional microvascular anastomoses supercharge in colonic interposition for thoracic esophageal replacement.
The free jejunal transfer success rate was 95.3% (122/128). Seventy-four patients undergoing typical reconstruction for hypopharyngeal cancer were reviewed. The fistula formation rate in anal and oral anastomosis was 4.1% (3 of 74) and 9.5% (7 of 74).
Twenty-nine patients underwent colonic pedicle interposition with additional microvascular anastomosis (supercharge). The middle colic artery and vein were the major donor vessels (17), and the internal mammary artery and vein were the major recipient vessels (18). Twenty-nine patients who had undergone colonic pedicle operation with supercharge were compared and reviewed with twenty-four patient who had had reconstruction without supercharge. The supercharged group was superior than the other group in terms of its fistula formation rate (p=0.01), the period which was needed for resumption of an oral diet after the operation and the average hospital stay.
Gastric pedicle with free jejunal interposition was performed in 21 patients. Fourteen of 21 patients underwent these operations because of a double cancer.
