Free jejunal autograft reconstruction after total pharyngolaryngeal resection.

A free jejunal autograft reconstruction after debulking high stage larynx and hypopharynx tumors has become a popular method in our 10-year experience. We retrospectively studied the efficacy and outcome. Nine patients (M/F, 8/1) underwent a total of 10 free jejunal autograft reconstructions. The median age was 58.6 years (range, 48-78 years). The median hospital stay was 32 days (range, 13-67 days) and the graft failure rate was 10% (1/10), 9/10 successfully retransplanted. Postoperative mortality rate was 0%; one patient was lost during follow-up, one patient died of lung cancer, three died of local recurrence, and four patients have no evidence of disease at this moment (mean follow-up of 16.5 months; range, 9-41 months). Salivation fistulas were present postoperatively in four patients: one closed spontaneously and three closed after surgery. In our hands, the free jejunal graft is the preferred method for single-stage reconstruction of circumferential defects of the gullet.