ANALYSIS OF RECURRENCE, COMPLICATIONS, AND FUNCTIONAL RESULTS WITH FREE JEJUNAL FLAPS

The medical records of 20 patients undergoing revascularized jejunal f lap reconstruction of hypopharyngeal defects were retrospectively revi ewed to analyze the incidence of distal marginal recurrence, complicat ion rates, and success of early functional restoration. This report is one of few in the literature to address distal marginal recurrence in patients undergoing jejunal free flap reconstruction of hypopharyngea l defects. In 15 evaluable patients, two (13%) developed distal margin al recurrences. Both patients had tumor involving the hypopharynx at t he junction of the cervical esophagus. The major complication rate was five of 20 patients (25%) and included three flap failures, one death , and one intra-abdominal hemorrhage. The minor complication rate was 35%. The median hospital stay was 15.5 days and the median time to suc cessful swallowing was 14.5 days. The functional success rate for swal lowing was 58%. Because of the aggressive nature of this disease, we f eel partial esophagectomy with jejunal flap reconstruction is warrante d to achieve early functional restoration in a select group of patient s when a 2-cm distal margin can be obtained above the cervical esophag us with frozen-section control, and the distal esophagus is normal.