RECONSTRUCTION BY FREE JEJUNAL TRANSPLANT AFTER CIRCULAR PHARYNGO-LARYNGECTOMY (FUNCTIONAL RESULTS AND SURVIVAL)

One hundred and ninety seven patients with cancer of the hypopharynx u nderwent after circular resection, reconstruction with a free jejunal graft. The quality of free jejunal grafts is controlled by many invest igations : clinical examination, radiography, electromyography, fibros copy with biopsy. These investigations show that technically jejunal g rafts must be short and linear to give the best functional results. Av erage resumption of oral intake was 14 days. Oral feeding was possible in 92 % of cases. The free jejunal grafts with microsurgery are one o f the more reliable procedures for reconstruction of pharynx and cervi cal esophagus after resection for cancer. (2 post-operative deaths and 8 grafts necrosis on 197 cases). The cumulative survival rate of 5 ye ars was 35 % for free jejunal graft. Survival depends on selection of the patients for local and nodes invasion. The quality of survival has improved. This operation must be reserved for the hypopharyngeal canc ers which need a circular resection and do not invade the esophagus. T he surgery is performed for a curative aim. The distant follow up of t he patients is imperative : consultation every four months and then ev ery six months : clinical examination, endoscopic, E.N.T., bronchial, and esophageal investigation. Chemotherapy and radiotherapy have speci fic indications.