Abstract
Free jejunal transfer using microsurgery after oesophageal or pharyngeal cancer resection is a useful operative approach. However, the disadvantage of free tissue transfer is the risk of necrosis of the transferred tissue due to impaired blood supply. In addition, jejunal flaps are more prone to blood-flow disorders such as ischaemia and congestion compared with other types of flaps. The causes of local blood supply disorders after microsurgery are divided broadly into two classes: one is thrombosis of an artery and/or vein in the anastomotic region and the other consists of local physical factors such as compressive pressure derived from haematoma formation and the effect of infection of the vascular pedicle. In this report, two rare cases of blood-flow disorder of the transferred free jejunum are described. In both cases, no signs of significant infection or occlusion of the vascular pedicles were present and late necrosis progressed gradually. The patients showed remarkable weight loss and a poor nutritional state due to inadequate preoperative nutritional intake. The necrosis was considered to be a result of non-occlusive mesenteric ischaemia of a free jejunal flap, and the factors contributing to free jejunal necrosis were reviewed.
| Original language | English |
|---|---|
| Journal | Journal of Plastic, Reconstructive and Aesthetic Surgery |
| Volume | 66 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2013 |
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Keywords
- Free jejunal flap
- Non-occlusive mesenteric ischaemia
- Preshock
- Secondary reconstruction
- Thrombosis
ASJC Scopus subject areas
- Surgery
Cite this
Non-occlusive mesenteric ischaemia of a free jejunal flap. / Onoda, Satoshi; Kimata, Yoshihiro; Yamada, Kiyoshi; Koshimune, Seijiro; Onoda, Tomoo; Shirakawa, Yasuhiro.
In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 66, No. 5, 05.2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Non-occlusive mesenteric ischaemia of a free jejunal flap
AU - Onoda, Satoshi
AU - Kimata, Yoshihiro
AU - Yamada, Kiyoshi
AU - Koshimune, Seijiro
AU - Onoda, Tomoo
AU - Shirakawa, Yasuhiro
PY - 2013/5
Y1 - 2013/5
N2 - Free jejunal transfer using microsurgery after oesophageal or pharyngeal cancer resection is a useful operative approach. However, the disadvantage of free tissue transfer is the risk of necrosis of the transferred tissue due to impaired blood supply. In addition, jejunal flaps are more prone to blood-flow disorders such as ischaemia and congestion compared with other types of flaps. The causes of local blood supply disorders after microsurgery are divided broadly into two classes: one is thrombosis of an artery and/or vein in the anastomotic region and the other consists of local physical factors such as compressive pressure derived from haematoma formation and the effect of infection of the vascular pedicle. In this report, two rare cases of blood-flow disorder of the transferred free jejunum are described. In both cases, no signs of significant infection or occlusion of the vascular pedicles were present and late necrosis progressed gradually. The patients showed remarkable weight loss and a poor nutritional state due to inadequate preoperative nutritional intake. The necrosis was considered to be a result of non-occlusive mesenteric ischaemia of a free jejunal flap, and the factors contributing to free jejunal necrosis were reviewed.
AB - Free jejunal transfer using microsurgery after oesophageal or pharyngeal cancer resection is a useful operative approach. However, the disadvantage of free tissue transfer is the risk of necrosis of the transferred tissue due to impaired blood supply. In addition, jejunal flaps are more prone to blood-flow disorders such as ischaemia and congestion compared with other types of flaps. The causes of local blood supply disorders after microsurgery are divided broadly into two classes: one is thrombosis of an artery and/or vein in the anastomotic region and the other consists of local physical factors such as compressive pressure derived from haematoma formation and the effect of infection of the vascular pedicle. In this report, two rare cases of blood-flow disorder of the transferred free jejunum are described. In both cases, no signs of significant infection or occlusion of the vascular pedicles were present and late necrosis progressed gradually. The patients showed remarkable weight loss and a poor nutritional state due to inadequate preoperative nutritional intake. The necrosis was considered to be a result of non-occlusive mesenteric ischaemia of a free jejunal flap, and the factors contributing to free jejunal necrosis were reviewed.
KW - Free jejunal flap
KW - Non-occlusive mesenteric ischaemia
KW - Preshock
KW - Secondary reconstruction
KW - Thrombosis
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UR - http://www.scopus.com/inward/citedby.url?scp=84875707569&partnerID=8YFLogxK
U2 - 10.1016/j.bjps.2012.12.031
DO - 10.1016/j.bjps.2012.12.031
M3 - Article
VL - 66
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
SN - 1748-6815
IS - 5
ER -