Pharyngoesophageal Reconstruction Using a Fabricated Forearm Free Flap

Harii, Kiyonori; Ebihara, Satoshi; Ono, Isamu; Saito, Hiroo; Terui, Shoji; Takato, Tsuyoshi

doi:10.1097/00006534-198504000-00002

Cited by 48 publications

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“…The lack of significant donor site complications, the availability of large quantities of pliable tissue, and the ability to use a 2-team approach has been sited by many as the major advantages. Many fasciocutaneous flaps have been described for the reconstruction of pharyngeal defects, including the radial forearm, 11 lateral thigh, 12 lateral arm, 13 scapular, 13 peroneal, 14 and the ulnar forearm. 15 The ALT has all the advantages of a fasciocutaneous reconstruction over the gastric pull-up or free jejunal transfer.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

et al. 2006

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“…These advances in reconstructive surgery have allowed surgical eradication of tumors which in the past were considered inoperable [5,6]. Today, major reconstruction following aggressive surgery for advanced primary tumors of the head and neck is commonly performed [7].…”

Section: Introductionmentioning

confidence: 99%

A Second Primary Squamous Cell Carcinoma Arising in a Radial Forearm Flap Used for Reconstruction of the Hypopharynx

Sakamoto¹,

Nibu²,

Sugasawa³

et al. 1998

ORL

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A 63-year-old man had undergone hypopharyngectomy for hypopharyngeal carcinoma in 1985. A free radial forearm flap was used for reconstruction of the pharynx. Ten years after the surgery, a second primary squamous cell carcinoma occurred in the neopharynx. Persistent exposure to alcohol, saliva and foodstuffs was considered as a possible cause of second primary carcinoma. Long-term follow-up is indicated in patients undergoing reconstruction using cutaneous or musculocutaneous flaps.

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“…Therefore, the circumference of anastomosis expands, and the line of a circular cicatrix stops. Harii recommends making a wave line in the fl apmucous contact (34). Nakatsuka indicates strictures in the use of jejunum in 9 %, and in the use of radial forearm fl ap in 39 % (30).…”

Section: Discussionmentioning

confidence: 99%

Primary reconstruction of pharyngo-oesophageal defects in oncologic patients

Palenčár

Kroslak²,

Fedeleś³

2013

BLL

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Abstract:Objectives: Majority of patients that undergo total or partial removal of the hypopharynx and cervical oesophagus are oncologic patients. Optimal management of head and neck malignancies requires multimodal therapy including surgical ablation, reconstruction, and adjuvant oncologic therapy. Despite aggressive surgical and adjuvant therapy, a fi ve-year survival rate is achieved only in 25-35 %. Methods: In the presented retrospective study, the choice of reconstructive method was infl uenced by type, length and extent of the defect, and condition of patient. The fl ap was indicated when the defect not allowed for primary suture of the hypopharynx and/or cervical oesophagus. Two-team approach was used. Results: The study was based on the data of ten patients. Radial forearm fl ap was used in 8 cases; pectoralis major myocutaneous fl ap was used in 3 patients, and ALT perforator free fl ap in 1 case. A total of 12 fl aps were used for 10 patients. Two patients developed free fl ap necrosis. These necrotic fl aps were substituted with pedicled pectoralis major myocutaneous fl aps. Conclusions:The primary reconstruction of the pharyngo-oesophageal defects could be the method of choice. For the partial defects, the best choice could be a radial forearm free fl ap. For circumferential defects, jejunal fl ap could be the best. The pectoralis major pedicled fl ap could be a safe procedure for elderly patients with multiple medical problems ( Tab. 6, Fig. 2, Ref. 34). Full Text in PDF www.elis.sk. Key words: pharynx reconstruction, pharyngo-oesophageal reconstruction, ALT perforator fl ap, free radial forearm fl ap, pectoralis major fl ap. Surgical resection of the hypopharynx and cervical oesophagus may lead to severe functional defi cits, and it may prevent the patient's peroral intake of solid food and liquids. This usually applies to patients with locally advanced laryngeal or hypopharyngeal malignancy. The treatment of these patients involves resection and reconstruction followed by radiotherapy. Surgical resection and reconstruction of the hypopharynx in patients suffering from advanced oncological disease is a challenge for surgeons, anaesthesiologists, nurses, and represents serious stress for patient.Resection of a small part of the hypopharynx or cervical oesophagus allows for primary suture of the defect, and it results in only minimal and temporary changes. Extensive resections require diffi cult reconstructions, often associated with free transfer of tissues. Despite the extensive surgical therapy and aggressive adjuvant therapy, fi ve-year survival of patients in stage III or IV of head and neck malignancies is only 25-35 % (1-3).Nowadays, the most favoured method is that of one-stage reconstruction of gastrointestinal tract continuity. The reconstructions of hypopharynx and cervical oesophagus have progressed from multiple-stage procedures using pedicle skin fl aps (4-8) to the use of pedicle fasciocutaneous, myocutaneous and visceral fl aps (9-15). The advent of microsurgical free fl aps has allo...

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Pharyngoesophageal Reconstruction Using a Fabricated Forearm Free Flap

Cited by 48 publications

References 0 publications

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

A Second Primary Squamous Cell Carcinoma Arising in a Radial Forearm Flap Used for Reconstruction of the Hypopharynx

Primary reconstruction of pharyngo-oesophageal defects in oncologic patients

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