Baku, June 18, AZERTAC Bulgarian surgeons at the Queen Ioanna - ISUL Hospital in Sofia have performed the country's first small-intestine transplant reconstruction of the cervical esophagus, preserving speech and swallowing in a patient with advanced cancer, the Bulgarian News Agency (BTA) reported. The surgery lasted more than 10 hours and was performed on a 58-year-old woman suffering from esophageal cancer, the hospital's press service said.The hospital described the procedure as an exceptionally complex and highly specialized surgical intervention carried out on a patient with a massive carcinoma of the cervical esophagus. The operation is considered a rare and technically demanding procedure even by international standards. Following the removal of the cervical esophagus, surgeons reconstructed the digestive tract using a free small-intestine graft.An additional challenge was the successful preservation of the patient's larynx, allowing her to retain the ability to speak, eat and breathe independently despite the advanced stage of the disease in this particularly sensitive anatomical area, the hospital said.During the operation, the team from the Department of Ear, Nose and Throat Diseases – Todor Popov MD, Lyuben Dimitrov MD, Kristina Komitova MD, and nurse Ani Spasova, performed the radical removal of the tumour along with the affected metastatic cervical lymph nodes. They subsequently reconstructed the extensive defect in the neck region through the autotransplantation of a 20-centimetre segment of small intestine.A second team led by Georgi Zhelev MD, together with Miroslav Arabadzhiev MD, Todor Yanev MD, and nurse Irina Misheva, harvested and prepared the intestinal graft for transplantation while simultaneously restoring the continuity of the patient's intestinal tract.The anaesthesiology team, consisting of Tsvetomir Marinov MD and nurse Teodora Ranova, maintained the patient's vital functions throughout the lengthy procedure.The patient was discharged from hospital one month after the operation.