Abstract
We herein report a rare case of a patient with hypopharyngeal squamous cell carcinoma
(SCC) who presented with recurrent metastasis in the mesenteric lymph node of a transplanted
jejunum. Removal of the metastatic lymph node required resection of the nutrient vessels
which risked the current state of the transplanted jejunum. Importantly, although
the nutrient vessels were resected, the jejunum did not become necrotic. This case
and another similar case indicate that it may be possible to predict the viability
of a transplanted jejunum where jejunal nutrient vessels must subsequently be resected.
Key indicators for jejunal survival include determining jejunal blood flow by intraoperative
indocyanine green fluorescence imaging, confirming good jejunal color and observation
of peristaltic movement by intraoperative blood flow blockage of nutrient vessels.
In conclusion, if intraoperative indocyanine green fluorescence imaging in the entire
jejunum can be confirmed, there is a high possibility that the jejunum can be well
preserved. The clinical presentation and clinical course are described with a proposed
new schema of the resectable site of the transplanted jejunal mesentery.
Keywords
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Article info
Publication history
Published online: December 28, 2022
Accepted:
December 21,
2022
Received:
September 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
