Reconstruction of the jejunoesophageal anastomosis with a circular mechanical stapler in total laryngopharyngectomy defects

作者：Schneider Daniel S^*; Gross Neil D; Sheppard Brett C; Wax Mark K

来源：Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, 2012, 34(5): 721-726.

DOI：10.1002/hed.21806

• circular mechanical stapler
• jejunal free flap
• total laryngopharyngectomy

Background The aim of this study was to demonstrate the technical feasibility and potential benefits of using a circular mechanical stapler with free jejunal transfer for jejunoesophageal anastomosis in total laryngopharyngectomy reconstruction while comparing the rates of fistula and stricture. %26lt;br%26gt;Methods. This study was a retrospective review of 12 free jejunal flaps completed with circular mechanical stapler for the jejunoesophageal anastomosis with comparison to 17 jejunal free flaps where all anastomoses were hand sewn. %26lt;br%26gt;Results. In all, 29 patients underwent free jejunal transfer: 12 had jejunal free flap with circular mechanical stapler for jejunoesophageal anastomosis, whereas 17 patients had handsewn anastomosis. Corresponding rates of fistula and stricture were 0/12 fistulas and 3/12 strictures in the stapler cohort and 2/17 fistulas with 0/17 strictures in the hand-sewn cohort. No statistically significant difference in rate of fistula was observed between each cohort, whereas a trend toward increased rate of stricture (p=.06) was observed in the stapled anastomosis cohort. %26lt;br%26gt;Conclusions. Use of circular mechanical stapler appears to be a safe and effective technique at the jejunoesophageal anastomosis for total laryngopharyngeal defects with comparable fistula and stricture rates to grafts that are hand sewn.

• 出版日期2012-5