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
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
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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U2 - 10.1016/j.bjps.2012.12.031
DO - 10.1016/j.bjps.2012.12.031
M3 - Article
C2 - 23395151
AN - SCOPUS:84875707569
VL - 66
SP - e133-e136
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
SN - 1748-6815
IS - 5
ER -