Non-occlusive mesenteric ischaemia of a free jejunal flap

Satoshi Onoda, Yoshihiro Kimata, Kiyoshi Yamada, Seijiro Koshimune, Tomoo Onoda, Yasuhiro Shirakawa

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume66
Issue number5
DOIs
Publication statusPublished - May 2013

Fingerprint

Free Tissue Flaps
Necrosis
Microsurgery
Blood Vessels
Pharyngeal Neoplasms
Jejunum
Esophageal Neoplasms
Infection
Hematoma
Weight Loss
Veins
Thrombosis
Ischemia
Arteries
Pressure
Mesenteric Ischemia

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 journalArticle

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