Analysis of postoperative complications after conduit reconstruction using free jejunum graft

Postoperative complications were evaluated in 139 patients who had undergone conduit reconstruction with free jejunum grafts after total pharyngolaryngoesophagectomy from 1999 through 2004. The patients included 119 men and 20 women, with a mean age of 64.3 years. Factors affecting the development of postoperative complications at the surgical site were analyzed. Postoperative complications at the surgical site were observed in 32 patients (23%) and included total necrosis of the transferred jejunum (2 patients), local abscess (13 patients), lymphorrhea (4 patients), major leakage (4 patients), minor leakage (5 patients), cervical skin necrosis (3 patients), hematoma (2 patients), and flap congestion (1 patient). Statistical analysis revealed that neither preoperative irradiation nor diabetes mellitus affected the rate of postoperative complications. However, small fistulae or local infections may easily develop into a severe complication in patients who have received radiotherapy. In such patients, careful treatment after reconstructive surgery is needed to avoid severe complications.