Abstract
Reconstructive operation using a free jejunal graft that was doublefolded and pouched with a use of an endostapler was perfomed after phyngolaryngectomy in three patients with infrapharyngeal cancer. The grafting was successful in all patients without any complication due to the procedures. Free jejunal graft which has the histological advantage in that it restores the continuity of the mucous membrane, has become the first choice tissue material for reconstructive surgery because of recent technical progress and spread of the microvascular surgery. However, the graft is replaced merely as a passive conduit in the pharyngolaryngectomy that would deteriorate the second phase of the physiological swallowing. There should be some place to pursue the optimal design of the graft conduit for satisfactory passage. We report our trial to make the doublefolded pouched jejunal graft using the staplers, so that the long defect between the pharyngeal end and the esophagus with large caliber discrepancy can be reconstructed conceptually in a simple straight end to end anastomosis.
