Jejunal free flap reconstruction of the pharyngolaryngectomy defect: 368 Consecutive cases

Perez-Smith, Diana; Wagels, Michael; Theile, David E.

doi:10.1016/j.bjps.2012.08.033

Cited by 71 publications

(82 citation statements)

References 37 publications

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“…Luckily, the two patients recovered after about 6-7 weeks of dressing change. Smith reported reconstruction of the hypopharynx by jejunal free flap in 386 cases; the average time to swallow is 12 days [16], shorter than our patients'. However, we took a conservative strategy on oral food intake in order to reduce the risk of infection.…”

Section: Discussioncontrasting

confidence: 73%

Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects

Yang

et al. 2016

Eur Arch Otorhinolaryngol

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Acellular dermal matrix (ADM) can be used as a new membrane substitute for repairing mucosal defects. The objective of this study is to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in hypopharynx reconstruction. A total of 40 patients were treated with this surgical method to reconstruct hypopharynx in our department between February 2011 and October 2012. Patients were diagnosed had hypopharyngeal cancer located at lateral and/or postpharyngeal wall. The mucosal defect size after hypopharyngeal resection was 3 × 4 cm-6 × 7 cm, and was repaired by xeno-ADM. Patients were followed up for 11-36 months. 4 patients got infected, and two developed into pharyngeal fistula. Patients regained eating function 2-5 weeks after surgery. No membrane was removed; no severe stenosis of hypopharynx was observed. All patients were successfully decannulated. The overall 3-year survival rate is 67.5 %; the 3-year disease-free rate is 47.5 %. Reconstruction of hypopharynx by xeno-ADM is proved to be a simple, safe and effective method with fewer complications.

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Section: Discussioncontrasting

confidence: 73%

Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects

Yang

et al. 2016

Eur Arch Otorhinolaryngol

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“…Since Seidenberg et al introduced reconstruction with an FJG in 1959 [14] the procedure has become popular for treating hypopharyngeal carcinoma and some cases of cervical esophageal carcinoma [2,4]. Reconstruction with an FJG is considered superior to reconstruction with a muscle or skin flap [4] because non-digestive conduits lacks peristaltic function and a mucous lining, which may be associated with difficulty swallowing or passing food.…”

Section: Discussionmentioning

confidence: 99%

“…Reconstruction with an FJG is considered superior to reconstruction with a muscle or skin flap [4] because non-digestive conduits lacks peristaltic function and a mucous lining, which may be associated with difficulty swallowing or passing food. However, the procedure is technically demanding.…”

Section: Discussionmentioning

confidence: 99%

“…Although microvascular reconstruction has greatly improved, there remains much room for improvement and further study. Particularly, the rate of graft failure mainly as a result of graft malperfusion is between 3% and 24% [3,4,15]. A necrotic FJG transferred to the neck is a life-threatening complication because it is adjacent to major vessels, such as the carotid arteries and the jugular veins, that can become infected by necrotic tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, significant efforts have been made to establish a reliable postoperative monitoring method, such as monitoring of intramucosal pH by tonometer [23], endoscopic observation [24], and Doppler ultrasound monitoring of FJG [24]. Some surgeons prefer to monitor flaps through the small window of the neck incision until the second or third postoperative day [4,25]. Using the monitor flap technique in which a portion of FJG is brought out, ICG fluorescence angiography can be applied postoperatively in the intensive care unit to check the perfusion status of the flaps.…”

Section: Discussionmentioning

confidence: 99%

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