Jurkiewicz M J
J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 2):893-7.
Free heterotopic transplantation of segments of the distal alimentary tract revascularized in the neck provide a very satisfactory, straightforward method of reconstruction of the cervical esophagus. At present pharyngoesophageal reconstructions are of four major types: (1) free skin grafts; (2) local or regional skin flaps; (3) subcutaneous or intrathoracic interposition or migration on a vascular pedicle of more distal positions of the alimentary tract--stomach or colon; and (4) a free graft of jejunum or colon. This report is an account of each of these methods with an emphasis on free revascularized grafts of the jejunum. Fifty-five such reconstructions have been performed at Emory Affiliated Hospitals. There were six graft failures for a transfer reliability of 90%. There were three perioperative deaths for a perioperative mortality of 5%. Comparison with similar reported series using either direct esophagogastric anastomosis, colon interposition, or staged deltopectoral skin flap reconstruction would suggest that the free jejunal graft procedure has lower morbidity and mortality. I believe it to be the method of choice in reconstruction of the cervical esophagus.
在颈部进行血管再通的远端消化道节段的游离异位移植，为重建颈段食管提供了一种非常令人满意且直接的方法。目前，咽食管重建主要有四种类型：（1）游离皮片移植；（2）局部或区域皮瓣；（3）消化道更远端部位（胃或结肠）带血管蒂的皮下或胸内植入或移位；（4）空肠或结肠游离移植。本报告阐述了上述每种方法，并重点介绍了空肠游离血管再通移植。埃默里附属医院已进行了55例此类重建手术。有6例移植失败，移植成功率为90%。围手术期死亡3例，围手术期死亡率为5%。与使用直接食管胃吻合术、结肠植入或分期胸大肌皮瓣重建的类似报道系列相比，游离空肠移植手术的发病率和死亡率更低。我认为它是颈段食管重建的首选方法。
