{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T13:50:36Z","timestamp":1758808236352,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report a case of a second free jejunal transfer to treat metastasis in the mesenteric lymph node of the first jejunal flap. A 73-year-old man underwent total pharyngolaryngectomy, bilateral neck dissection, and free jejunal transfer for recurrent hypopharyngeal cancer [left pyriform sinus, pT2N0, moderately differentiated squamous cell carcinoma (SCC)] after radiotherapy. Seven years post-surgery, he underwent transoral videolaryngoscopic surgery for oropharyngeal cancer (soft palate, pT1N0, well-differentiated SCC). Ten years after the first jejunal transfer, metastasis was found in the mesenteric lymph node surrounding the jejunal flap\u2019s vascular pedicle. Under general anesthesia, resection of the first jejunum including the affected lymph node, and second jejunal transfer were performed. Lymph node pathological examination revealed poorly differentiated SCC, compatible with pharyngeal cancer metastasis. After neck dissection and jejunal flap transfer, lymphatic collateral pathways toward the flap\u2019s mesenteric lymph node might form. Possibly, hypopharyngeal or oropharyngeal cancer metastasized via this pathway.<\/jats:p>","DOI":"10.1093\/jscr\/rjad686","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T04:35:30Z","timestamp":1703824530000},"source":"Crossref","is-referenced-by-count":1,"title":["Salvage surgery for mesenteric lymph node metastasis by resection of the first jejunal flap and reconstruction with the second jejunal flap"],"prefix":"10.1093","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4448-8963","authenticated-orcid":false,"given":"Daiki","family":"Kitano","sequence":"first","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunobu","family":"Hashikawa","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine , Nagoya , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kotaro","family":"Tamagawa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Sakakibara","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken-ichi","family":"Nibu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Terashi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Kobe University Graduate School of Medicine , Kobe , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"2023122904352004800_ref1","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00595-008-4050-x","article-title":"Free jejunal graft reconstruction after resection of neck cancers: our surgical technique","volume":"39","author":"Ikeguchi","year":"2009","journal-title":"Surg Today"},{"key":"2023122904352004800_ref2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/02844319850158651","article-title":"Comparative evaluation in pharyngo-oesophageal reconstruction radial forearm flap compared with jejunal flap. 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