MORBIDITY AND FUNCTIONAL OUTCOME OF FREE JEJUNAL TRANSFER RECONSTRUCTION FOR CIRCUMFERENTIAL DEFECTS OF THE PHARYNX AND CERVICAL ESOPHAGUS

Free jejunal transfer has been criticized by some surgeons as unreliab le, poorly tolerant of radiation therapy, and associated with signific ant morbidity and dysphagia. To determine the validity of these critic isms, we reviewed 93 patients who underwent 96 free jejunal transfers for repair of circumferential pharyngoesophageal defects over a 5-year period. The free jejunal transfer success rate was 97 percent; all 3 failures were repaired with repeated free jejunal transfer. The compli cation rate was 57 percent (55 of 96); fistula (19 percent) and strict ure (15 percent) were the most common complications. An oral diet was tolerated by 80 percent of patients; 85 percent of these resumed their diet within 2 weeks of surgery. Causes of dysphagia were multifactori al. Postoperative radiation therapy did not increase morbidity or dysp hagia. The perioperative mortality rate was 2 percent. We conclude tha t free jejunal transfer is a reliable method of pharyngoesophageal rec onstruction that has an acceptable morbidity rate and a low mortality rate. Postoperative radiation therapy is well tolerated by the free je junal transfer.