{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T11:04:11Z","timestamp":1784372651570,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,8,27]],"date-time":"2018-08-27T00:00:00Z","timestamp":1535328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>When pharyngoesophagectomy is performed in conjunction with anterior mediastinal tracheostomy, reconstructing both the trachea and alimentary tract is extremely difficult. We developed a novel 1\u2010stage reconstructive procedure using a single free jejunal flap containing multiple vascular pedicles to decrease postoperative morbidity and mortality. Free jejunal flap transfer with multiple vascular pedicles could offer a viable option for reducing associated life\u2010threatening complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of 34 patients who underwent free jejunal flap transfer with multiple vascular pedicles in anterior mediastinal tracheostomy and pharyngoesophagectomy due to lesions involving both the airway and esophagus. In all cases, 1\u2010stage reconstruction of the digestive tract and trachea was performed. Technical details and outcomes were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 34 jejunal flaps (100%) survived. Major morbidity classified as Clavien\u2013Dindo grades III and IV occurred in 10 (29.4%) and 0 (0%) patients, respectively during hospitalization. With regard to common complications, anastomotic leakage from transferred jejunal flaps and surgical site infections occurred in 0 (0%) and 7 (20.6%) patients, respectively. Five (14.7%) patients experienced tracheal stoma dehiscence. Donor site morbidity was observed in 2 (5.9%) patients. The overall in\u2010hospital mortality rate was 2.9%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our 1\u2010stage reconstruction procedure achieved low morbidity and low mortality rates following anterior mediastinal tracheostomy and pharyngoesophagectomy. Only 1 jejunal flap transfer is needed to simultaneously reconstruct the trachea and alimentary tract in a safe and reliable manner with this procedure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30359","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T21:33:41Z","timestamp":1535578421000},"page":"852-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1402-5383","authenticated-orcid":false,"given":"Tateki","family":"Kubo","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Kurita","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Osaka Prefectural Hospital Organization, Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Tashima","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Osaka Prefectural Hospital Organization, Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shien","family":"Seike","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Osaka Prefectural Hospital Organization, Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Osaka Prefectural Hospital Organization, Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Doki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Hosokawa","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0218492312456849"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.04.103"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988008800407"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.03.021"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21852"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23730"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198984040-00005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.01.044"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22382"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.10.100"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/229255031202000213"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0022-5223(19)43343-6","article-title":"Terminal or mural tracheostomy in the anterior mediastinum","volume":"51","author":"Grillo H. 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