Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases

World Journal of Surgical Oncology

Research

Ashraf Khater¹  Fayez Shahatto¹  Waleed Elnahas¹  Mohamed T Hafez¹  Osama Hussein¹  Sameh Roshdy¹  Sherif Kotb¹  Adel Denewer¹  Khaled Mowafy² 

[1] Department of Surgical Oncology, Oncology Center (OCMU), Mansoura, Daqahlia, Egypt;Vascular Surgery, Mansoura University, Mansoura, Egypt;

关键词: Gastric Tube;    Free Flap;    Myocutaneous Flap;    Hypopharyngeal Carcinoma;    Pectoralis Major Myocutaneous Flap;   

DOI  :  10.1186/1477-7819-12-182

 received in 2014-01-01, accepted in 2014-05-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma.MethodsOne hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment.ResultsPectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases. Mean hospital stay was 12 days. Mortality rate was 10.6% and morbidity rate was 31.7%. Total flap failure occurred in 3 cases of free flap and one case of pectoralis flap. There were 23 cases of early fistula. Late stricture occurred in 19 cases, being highest with myocutaneous flap (early fistula 12/50 and late stricture 13/50).ConclusionFree jejunal flap was the flap of choice for reconstruction when the safety margin is still above the clavicle. In cases with added esophagectomy, we recommend gastric tube as a method of choice for reconstruction.

【 授权许可】

CC BY   
© Denewer et al.; licensee BioMed Central Ltd. 2014