Abstract
Total pharyngolaryngoesophagectomy （TPLE） is performed on patients with advanced head and neck cancer. It is most frequently followed by pharyngoesophageal reconstruction with free jejunal flap because there is a relatively low operative risk and it improves postoperative function of the reconstructed pharynx and esophagus. A 79-year-old man developed hypopharyngeal carcinoma and underwent TPLE, neck dissection on both sides, and free jejunal transfer at our hospital. Early after surgery, we conducted thrombectomy because obstruction by the artery anastomotic region occurred. Blood flow was improved by early thrombectomy, and the flap survived. However, a scarring stenosis which gradually reached full length occurred, and so we performed free jejunal transfer again. The pathological findings indicated that the mucosa had atrophied and been lost, while blood vessels were preserved. Even if the free jejunal flap survives early reoperation for vascular problems
after TPLE, it may gradually develop scarring and stenosis.
