Theile D R, Robinson D W, Theile D E, Coman W B
Head and Neck Clinic, Princess Alexandria Hospital, Brisbane, Australia.
Head Neck. 1995 Mar-Apr;17(2):83-8. doi: 10.1002/hed.2880170202.
Reconstruction of tubular defects following pharyngolaryngectomy has required complicated surgery with high perioperative morbidity and mortality. Free jejunal interposition provides an excellent reconstruction with potential for lower immediate complications and better long-term results than other procedures.
A total of 201 consecutive free jejunal interpositions were performed following pharyngolaryngectomy between 1977 and 1993. Operative details, complications, and outcome were prospectively documented.
Perioperative mortality was low (4.5%) and microvascular success rate high (97%), although a small number of late failures were recorded. Average time until swallowing postoperatively was 11 days, and 92% of patients could maintain full nutrition. Voice rehabilitation was mentioned, and increasingly good results are being obtained. Complication rates for the neck (17%) and the abdomen (2.5%) were also low. There were no problems with excess mucus production or reflux. Radiation effect on the jejunal conduit was not detrimental to long-term patency of the vascular anastomoses or to function as a conduit.
Comparison with other published techniques permits the contention that a free jejunal interposition is the reconstruction of choice after pharyngolaryngectomy.
喉咽切除术后管状缺损的重建需要复杂的手术，围手术期发病率和死亡率较高。游离空肠移植提供了一种出色的重建方式，与其他手术相比，其即时并发症可能更少，长期效果更好。
1977年至1993年间，共对201例喉咽切除术后患者进行了游离空肠移植。前瞻性记录了手术细节、并发症和结果。
围手术期死亡率较低（4.5%），微血管成功率较高（97%），尽管记录到少数晚期失败病例。术后平均吞咽时间为11天，92%的患者能够维持完全营养。提及了嗓音重建，且取得了越来越好的效果。颈部并发症发生率（17%）和腹部并发症发生率（2.5%）也较低。没有过多黏液产生或反流的问题。放疗对空肠管道的影响对血管吻合口的长期通畅性或管道功能并无不利影响。
与其他已发表的技术相比，可以认为游离空肠移植是喉咽切除术后重建的首选方法。
