Abstract
Purpose
To assess the effective distribution of blood supply in jejunal graft with the 3rd intestinal artery as pedicle and to afford a reliable theoretic base for clinical esophageal reconstruction.
Methods
Thirty-two formalin-preserved and 21 fresh cadaver specimens were studied with anatomic measurement, acetic ester perfusion, and Acrylonitrile butadiene styrene (ABS) vascular casting specimen.
Results
Results demonstrate there is no significant variation of vascular in the two groups. The inner diameter of the 3rd intestinal artery is comparatively larger among five intestinal arteries. There is a wider distribution of efficient blood supply in the 3rd intestinal artery. The mean (SD) length of homogenously stained jejunum segment, and the mean (SD) ABS effective distributing length of extended arches are 142.2 (62.3) cm and 30.8 (7.3) cm, respectively.
Conclusions
The 3rd intestinal artery as pedicle can afford adequate blood supply to the jejunum segment and has effective arterial arch with enough length; thus it meets the need of esophageal reconstruction.
Similar content being viewed by others
References
Bradford CR, Esclamado RM, Carroll WR (1992) Monitoring of revascularized jejunal autografts. Arch Otolaryngol Head Neck Surg 118:1042–1044
Chen MF, Li ZH (1993) The design and manufacture of vascular casting for abdominal surgery. Chin J Clin Anat 11:71 In chinese
Dionyssopoulos A, Harris PG, Karagergou E et al (2010) Monitoring of free jejunal transfer. J Plast Reconstr Aesthet Surg 63:e209–e210
Dionyssopoulos A, Odobescu A, Foroughi Y et al (2012) Monitoring buried jejunum free flaps with a sentinel: a retrospective study of 20 cases. Laryngoscope 122:519–522
Hirano T, Fujita K, Kodama S et al (2010) Survival of a free jejunal flap with venous occlusion. Ann Thorac Surg 89:1656–1659
Hu RL (1987) Survey for the Superior Mesenteric Artery and Intestinal Branches. Chin J Anat 10:127 (in chinese)
Miyamoto S, Minabe T, Harii K (2011) Effect of recipient arterial blood inflow on free flap survival area. Plast Reconstr Surg 121:505–513
Moradi P, Glass GE, Atherton DD et al (2010) Reconstruction of pharyngolaryngectomy defects using the jejunal free flap: a 10-year experience from a single reconstructive center. Plast Reconstr Surg 126:1960–1966
Nagasao T, Shimizu Y, Kasai S et al (2012) Extension of the jejunum in the reconstruction of cervical oesophagus with free jejunum transfer using the thoracoacrominal vessels as recipients. J Plast Reconstr Aesthet Surg 65:156–162
Numajiri T, Fujiwara T, Nishino K et al (2010) Artery-dominant free jejunal transfer. Plast Reconstr Aesthet Surg 63:446–450
Numajiri T, Sowa Y, Nishino K et al (2010) Double vascular anastomosis in the neck for reliable free jejunal transfer. Br J Oral Maxillofac Surg 48:511–514
Numajiri T, Sowa Y, Nishino K et al (2011) Blood gas analyses in doubly-vascularised free jejunal transfers. Br J Oral Maxillofac Surg 49:112–115
Onoda S, Kimata Y, Yamada K et al (2011) The best salvage operation method after total necrosis of a free jejunal graft? Transfer of a second free jejunal graft. J Plast Reconstr Aesthet Surg 64:1030–1034
Ott K, Lordick F, Molls M et al (2009) Limited resection and free jejunal graft interposition for squamous cell carcinoma of the cervical oesophagus. Br J Surg 96:258–266
Ouyang Z, Liu P, Yu Y et al (2011) Role of ovarian artery-to-uterine artery anastomoses in uterine artery embolization: initial anatomic and radiologic studies. Surg Radiol Anat 33:547–550
Perez M, Haumont T, Arnoux JM et al (2010) Anatomically based comparison of the different transthoracic routes for colon ascension after total esogastrectomy. Surg Radiol Anat 32:63–68
Shirakawa Y, Naomoto Y, Noma K et al (2004) Free jejunal graft for hypopharyngeal and esophageal reconstruction. Langenbecks Arch Surg 389:387–390
Takamatsu A, Harashina T, Inoue T (1996) Selection of appropriate recipient vessels in difficult, microsurgical head and neck reconstruction. J Reconstr Microsurg 12:499–513
Ueda K, Harashina T, Oba S et al (1994) Which vessel is more important in the supercharged flap artery, vein, or both? An experimental study. J Reconstr Microsurg 10:153–155
Wallentin RS, Sørensen HB, Bundgaard T et al (2010) Reconstruction using free jejunal transfer after resection of cancer of the upper oesophagus. Dan Med Bull 57:A4164
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jiao, Hs., Shan, T., Cheng, Gl. et al. A novel blood supply method for free jejunal transfer with the third jejunal artery as vascular pedicle. Surg Radiol Anat 34, 953–957 (2012). https://doi.org/10.1007/s00276-012-0993-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-012-0993-0