Evaluation of Ischemic Time and Complications in Free Jejunum Transfer

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-09-11 DOI:10.1002/micr.31237
Mayu Suzuki, Jun Arata, Shuko Kaito
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Abstract

Background

In free jejunum transfer, knowing the ischemic tolerance time of the jejunum is crucial. It helps determine the need for reharvesting if an unexpected situation prolongs the ischemic time. The current ischemic tolerance time in humans is unknown. We investigated the relationship between ischemic time and postoperative complications in head and neck cancer patients who underwent free jejunum transfer.

Methods

The study included 76 patients with available medical records out of 103 patients who underwent free jejunum transfer between 2009 and 2023. The association between the surgical procedure, including ischemic time, and patient's background, and flap engraftment, stenosis of the intestinal anastomosis, the swallowing function, and other complications was investigated.

Results

The ischemic time for jejunal flaps ranged from 1 h 24 min to 6 h, with a mean of 197 ± 55.5 min. In 72 patients, the jejunum was successfully engrafted, but vascular occlusion occurred in another four patients. In three of these patients, jejunal necrosis occurred, and there was no specific trend in ischemic time. Stenosis of the intestinal anastomosis occurred in 17 cases (22%), with ischemic time (≥3 h) and age (≥75 years) being significant factors for stenosis (ischemic time: 30% vs. 10%, p = 0.048, age: 50% vs. 15%, p < 0.01). No significant correlations were observed with other complications or the swallowing function.

Conclusion

There was no specific trend between ischemic time and jejunal survival rate, indicating that an ischemic time within 6 h may not have affected engraftment. Although we have recently performed intestinal anastomosis prior to vascular anastomosis, the choice of surgical technique should be adapted to the patient's age and background.

评估游离空肠移植的缺血时间和并发症
背景 在游离空肠移植中,了解空肠的缺血耐受时间至关重要。如果出现意外情况导致缺血时间延长,它有助于确定是否需要重新采集。目前人类的缺血耐受时间尚不清楚。我们研究了接受游离空肠转移的头颈部癌症患者缺血时间与术后并发症之间的关系。 方法 研究纳入了 2009 年至 2023 年期间接受游离空肠转移术的 103 例患者中 76 例有病历记录的患者。研究了手术过程(包括缺血时间)、患者背景、皮瓣移植、肠吻合口狭窄、吞咽功能和其他并发症之间的关系。 结果 空肠皮瓣的缺血时间从 1 h 24 min 到 6 h 不等,平均为 197 ± 55.5 min。72 例患者成功移植了空肠,但有 4 例患者发生了血管闭塞。其中三名患者出现空肠坏死,缺血时间没有特定趋势。17例(22%)发生肠吻合口狭窄,缺血时间(≥3小时)和年龄(≥75岁)是导致狭窄的重要因素(缺血时间:30%对10%,P = 0.048;年龄:50%对15%,P < 0.01)。与其他并发症或吞咽功能无明显相关性。 结论 缺血时间与空肠存活率之间没有特定的趋势,表明缺血时间在6小时以内可能不会影响移植。虽然我们最近在血管吻合前进行了肠吻合术,但手术技术的选择应根据患者的年龄和背景而定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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