The Comparative Study of a Recostruction with Gastric Tube and Free Jejunal Autograft for Pharynx and/or Cervical Esophageal Carcinoma

Yukimitsu Kawaura, Masatoshi Sasaki, Kenji Omura, Eiji Kanehira, Yoshinori Munemoto, Nozomu Murakami, Atsushi Nagasato, Hiroshi Hikishima, Yoshihiro Mori, Takashi Iwa

Department of Surgery (I), Kanazawa University School of Medicine

Two reconstructive methods of operating on the pharynx and/or cervical esophagus were compared. The patients were divided into a reconstructive group of 7 cases (Gastric group) and a group of 14 cases with a free jejunal autograft without dissection of the mediastinal lymph nodes (FJA group). In the FJA group, complication in the respiratory system and anastomotic leakage did not occur, in contrast with the Gastric group in which there were 2 cases of respiratory disorders and 2 cases of anastomotic leakage, Mediastinal lymph node metastases was not seen in the Gastric group, but cervical paraesophageal lymph node metastases were found in 57.1% of the Gastric group and in 42.9% of the FJA group. These findings indicate that we should placed great importance on the dissection of the neck lymph nodes. In the patients with distant metastases, mediastinal lymph node metastases were found. Anastomotic stenosis and/or thrombus formation in a nutrient artery of FJA were not revealed by common carotid arteriography after the operation. The patient who survived the longest in the Gastric group survived 62 months and died of recurrence in the lung. In the FJA group, two patients have survived 5 years more. A significant difference in survival tme was not seen between the two groups. We emphasize that reconstruction with FJA is safe and benefical, especially in high-risk cases.

Key words
pharynx carcinoma, cervical esophageal carcinoma, reconstruction with gastric tube, reconstruction with free jejunal autograft

Reprint requests
Yukimitsu Kawaura The First Department of Surgery, Kanazawa University School of Medicine l3-1 Takara-machi, Kanazawa, 920 JAPAN

Accepted
December 13, 1989

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