D112. Placental Derived Tissue Allograft Reinforcement of Esophagojejunal Anastomosis Reduces Post-operative Complications

PURPOSE: The supercharged pedicled jejunum (SPJ) interposition flap has favorable attributes to restore gastrointestinal continuity following total esophagectomy when the gastric conduit is unavailable. These procedures can be challenging and can be associated with significant morbidity. Placental derived tissue allograft (PDTA) has potential clinical benefit for promoting wound healing through upregulation in basic fibroblast growth factor (FGF), granulocyte colony-stimulating factor, and placental grown factor by dermal fibroblasts. This is the first study to evaluate the use placental tissue allograft in SPJ for esophageal reconstruction. METHODS: A retrospective chart review of all patients who underwent a SPJ interposition flap was conducted. A comparison was performed between patients who received PDTA reinforcement at the cervical anastomosis and those who did not. RESULTS: Thirty-seven patients were included in this cohort; and 9 (24.3%) had PDTA reinforcement. Patient demographics did not differ in comorbidities nor radiation status between PDTA and standard groups (p=0.16). Post-operatively, the PDTA group had a significantly lower rate of anastomotic leaks (n=1) compared to standard group (n=10), p=0.02. The rate of fistulas was significantly reduced in the PDTA group (p<0.01). There were no significant differences in stricture rate (p=0.08). The PDTA group was significantly more likely (89%) to return to an oral diet at last follow up compared to 35.1% in the standard group (p=0.02). CONCLUSION: Initial results using placental derived tissue allograft reinforcement for esophagojejunal anastomosis demonstrates promising benefit at reducing significant complications associated with salvage esophageal reconstruction with supercharged jejunal flap.