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Truman M. Sasaki, MD; Harvey W. Baker, MD; Donald B. McConnell, MD; R. Mark Vetto, MD

Arch Surg. 1982;117(4):459-462.

Abstract
• We used microvascular anastomoses to transpose free pedicle jejunal mucosal patch grafts in seven patients. The procedure has been particularly helpful in rebuilding large intraoral mucosal defects created by extensive resections for advanced carcinomas. Some of the benefits of this technique have included a one-stage procedure, which requires two to three weeks for healing; abundant donor tissue with characteristics similar to oral mucosa; near-normal facial appearance; and preservation of maximum tongue function. An unexpected benefit has been relief of annoying xerostomia by the jejunal mucous secretion. The most severe complication, which resulted in one death, was the excessive oral jejunal mucous secretion in the early postoperative period. It led to significant aspiration pneumonitis. To prevent this problem, we recommend a routine tracheostomy combined with rigorous pulmonary care whenever a jejunal patch graft is used.

(Arch Surg 1982;117:459-462)

Author Affiliations
From the Department of Surgery, School of Medicine, University of Oregon Health Sciences Center, and the Surgical Service, Veterans Administration Medical Center, Portland.

Footnotes
Accepted for publication Nov 24, 1981.

Read at the Fifth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Minneapolis, May 14, 1981.

Reprint requests to Surgical Service, Veterans Administration Medical Center, 3710 SW US Veterans Hospital Rd, Portland, OR 97201 (Dr Sasaki).

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