Pharyngo-cervical Esophageal Reconstruction

Archibald, Stuart; Young, James K.; Thoma, Achilleas

doi:10.1016/j.cps.2005.01.002

Cited by 26 publications

(30 citation statements)

References 41 publications

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“…Although there are no complications with tubed RFFF, prolonged transit time is associated with a lack of motility and diminished lubrication of the wall in the neopharynx. 2 This supports our suggestion to use the remnant pharyngeal wall, regardless of size.…”

Section: Discussionsupporting

confidence: 82%

Hypopharyngeal Reconstruction Using Remnant Narrow Pharyngeal Wall as Omega-Shaped Radial Forearm Free Flap

Hong¹,

Jeong²,

Lew³

et al. 2009

Journal of Craniofacial Surgery

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Section: Discussionsupporting

confidence: 82%

Hypopharyngeal Reconstruction Using Remnant Narrow Pharyngeal Wall as Omega-Shaped Radial Forearm Free Flap

Hong¹,

Jeong²,

Lew³

et al. 2009

Journal of Craniofacial Surgery

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“…Pedicled colonic interposition or jejunal transfer is an alternative method that can be used when the gastric tube pull-up procedure is not applicable. 1,12 However, conduit ischemia and necrosis in the distal segment are high and carry the possibility of serious complications including mediastinitis and pneumonia. 8,13 In such situations, microvascular circulation enhancement, otherwise known as the supercharge technique, can increase blood circulation to the interposed conduit.…”

Section: Discussionmentioning

confidence: 99%

Extended left colon interposition for pharyngoesophageal reconstruction using distal‐end arterial enhancement

Kuo

Chien

2008

Microsurgery

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In pharyngoesophageal reconstruction with colon interposition, the oral segment of colon graft suffers from high incidence of ischemia necrosis. This leads to increased rate of fistula formation and hence increased mortality. This study described an arterial enhancement procedure for uncomplicated colon interposition. Five patients who had undergone pharyngoesophageal reconstruction with extended left colon interposition were reviewed, all of whom had advanced hypopharyngeal cancer with cervical esophagus invasion. Insufficient blood supply of the distal colon was noted following pharyngocolostomy. Arterial enhancement from the distal end of the sigmoid artery branch to the superior thyroid artery (four cases) or facial artery (one case) was performed. All patients displayed good circulation and peristalsis of colon interposition graft perioperatively. The pharyngocolostomy junction was free of leakage and colon graft necrosis. Barium study revealed a wide patent anastomosis postoperatively. Patients tolerated regular diet without problems following discharge. This demonstrated distal arterial enhancement procedure during extended colon interposition is a feasible technique for preventing serious complications for pharyngoesophageal reconstruction.

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“…1 Reconstruction of the esophagus is commonly achieved by a jejunal or fasciocutaneous free conduit transfer. Successful restoration of the digestive tract continuity along with anterior neck coverage is therefore critically important functionally and psychologically yet invariably challenging.…”

mentioning

confidence: 99%

Tube-in-a-Tube Anterolateral Thigh Flap for Reconstruction of a Complex Esophageal and Anterior Neck Defect

Komorowska-Timek

Lee

2014

Annals of Plastic Surgery

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Restoration of a functional digestive track along with acceptable external neck coverage traditionally requires 2 separate flaps. We present a case of a 65-year-old man with a large cervical and esophageal defect treated successfully with a single anterolateral thigh (ALT) free flap. This patient had been treated with primary chemoradiation for laryngeal cancer, and subsequently, developed a severe esophageal stricture. He had undergone prior multiple attempts at reconstruction with a pectoralis major, radial forearm, and deltopectoral flaps, skin grafts, and gastric pull-up, which had all failed. We used an ALT free flap that was designed in a "tube-in-a-tube" fashion to simultaneously reconstruct the cervical esophagus while resurfacing the anterior neck. The patient successfully restarted a liquid diet on the 19th postoperative day. Tube-in-a-tube ALT flap design is a reliable and efficient way to concurrently restore esophageal continuity and provide anterior neck coverage in a single-stage procedure.

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Pharyngo-cervical Esophageal Reconstruction

Cited by 26 publications

References 41 publications

Hypopharyngeal Reconstruction Using Remnant Narrow Pharyngeal Wall as Omega-Shaped Radial Forearm Free Flap

Hypopharyngeal Reconstruction Using Remnant Narrow Pharyngeal Wall as Omega-Shaped Radial Forearm Free Flap

Extended left colon interposition for pharyngoesophageal reconstruction using distal‐end arterial enhancement

Tube-in-a-Tube Anterolateral Thigh Flap for Reconstruction of a Complex Esophageal and Anterior Neck Defect

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