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Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature.

Publication ,  Journal Article
Küntscher, MV; Erdmann, D; Boltze, W-H; Germann, G
Published in: Spinal Cord
October 2003

STUDY DESIGN: : Single-subject (male, 16 years of age) case. OBJECTIVES: To demonstrate a suitable method for oesophageal repair after perforation as a complication of anterior spinal fusion in an individual with quadriplegia, and to review the literature on oesophageal perforation and repair. SETTING: University hospital, large trauma centre with departments for spinal injuries and reconstructive surgery in Germany. METHODS: A free jejunal graft used for oesophageal reconstruction in a post-traumatic situation after a complicated treatment course in a C6 quadriplegic patient. RESULTS: A protuberant loose screw of the titanium plate after anterior spinal fusion perforated the oesophagus. Imbricating sutures and a fascia lata patch were insufficient to repair the oesophageal leakage. An 8 cm long segment of the cervical oesophagus including a fistula had to be excised, and a free microsurgical jejunal flap was used for restitution of continuity. The jejunal vessels were connected to the superior thyroid artery and external jugular vein. At 1 week after the oesophageal repair, an enteral contrast study showed a small amount of contrast medium leaking at the oesophago-pharyngeal anastomosis. A percutaneous gastric tube was inserted, and oral feeding was limited to tea and still water for 4 weeks. The further course was uneventful. CONCLUSIONS: Oesophageal perforation is a rare but recognized complication after cervical spine surgery, which can mostly be managed using secondary suture techniques. The free jejunal flap is a reliable and innovative tool in the particularly complex situation of a segmental oesophageal loss. It should be considered in similar cases to reconstruct oesophageal continuity or to treat stricture and fistula formations.

Duke Scholars

Published In

Spinal Cord

DOI

ISSN

1362-4393

Publication Date

October 2003

Volume

41

Issue

10

Start / End Page

543 / 548

Location

England

Related Subject Headings

  • Surgical Flaps
  • Spinal Fusion
  • Spinal Cord Injuries
  • Rehabilitation
  • Radiography
  • Quadriplegia
  • Plastic Surgery Procedures
  • Male
  • Jejunum
  • Humans
 

Citation

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Küntscher, M. V., Erdmann, D., Boltze, W.-H., & Germann, G. (2003). Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature. Spinal Cord, 41(10), 543–548. https://doi.org/10.1038/sj.sc.3101439
Küntscher, M. V., D. Erdmann, W. -. H. Boltze, and G. Germann. “Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature.Spinal Cord 41, no. 10 (October 2003): 543–48. https://doi.org/10.1038/sj.sc.3101439.
Küntscher, M. V., et al. “Use of a free jejunal graft for oesophageal reconstruction following perforation after cervical spine surgery: case report and review of the literature.Spinal Cord, vol. 41, no. 10, Oct. 2003, pp. 543–48. Pubmed, doi:10.1038/sj.sc.3101439.

Published In

Spinal Cord

DOI

ISSN

1362-4393

Publication Date

October 2003

Volume

41

Issue

10

Start / End Page

543 / 548

Location

England

Related Subject Headings

  • Surgical Flaps
  • Spinal Fusion
  • Spinal Cord Injuries
  • Rehabilitation
  • Radiography
  • Quadriplegia
  • Plastic Surgery Procedures
  • Male
  • Jejunum
  • Humans