Objective: To explore the clinical effects and short-term complications of using free jejunum graft (FJG) to reconstruct the defects by resections of pharyngeal, laryngeal or cervical esophageal cancers.
Method: Fifty-eight cases of pharyngeal, laryngeal or cervical esophageal cancers were reconstructed with FJG. All cases were analyzed retrospectively.
Result: The success rate of FJG transplantations was 91.4% (53/58). The incidence of post-operative short-term complication was 43.1% (25/58), which was not related to age or BMI. The most common complication was anastomotic leakage (18.9%), which was not related to per-operative radiation therapy. However, BMI > 25 cases had significantly higher incidence of anastomotic leakage than BMI ≤ 25 cases (P = 0.009). The second and third most common complications were respiratory system complications (10. 3%) and FJG necrosis (8. 6%). Para-operative death rate was 3.4% (2/58). Two-year overall survival rates of hypopharyngeal cancer and cervical esophageal cancer were 49% and 67% respectively. The group with no short-term complications had a slightly better survival rate than the group with short-term complications from the Kaplan-Meier curve, but there was no significant difference (P = 0.103).
Conclusion: FJG is ideal to reconstruct cervical digestive tract circumferential defects with a high success rate and a low mortality. However, the post-operative complication rate is high. Intensive observation, early detection and timely treatment of complications are crucial.