Tubed pectoralis major myocutaneous flap for reconstruction of circumference pharyngoesophageal defects
10.3760/cma.j.issn.1673-0860.2010.05.012
- VernacularTitle:胸大肌肌皮瓣卷筒在下咽颈段食管环周缺损修复中的应用
- Author:
Wei XU
1
;
Zheng-Hua L(U)
;
Jun ZHANG
;
Ji-Dong ZOU
;
Hui-Zheng LI
;
Hong-Yuan CAO
;
Hai-Bo WANG
Author Information
1. 山东大学附属省立医院
- Keywords:
Pectoralis muscles;
Surgical flaps;
Hypopharyngeal neoplasms;
Reconstructive surgical procedures
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2010;45(5):401-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and efficacy of tubed pectoralis major myocutaneous flap in the reconstruction of circumferential defects following resection for locally advanced hypopharygeal and cervical esophageal carcinoma. Methods From Dec. 2004 to Oct 2008, 30 patients underwent immediate reconstruction by tubed pectoralis major myocutaneous flap for circumferential defects following resection of primary tumours. Among them, 22 were hypopharyngeal carcinoma, 7 were cervical esophageal carcinoma and one was recurrent laryngeal carcinoma involved the hypopharyngeal lumen. Five of 30 patients had received previous radiotherapy and three had failed in the previous surgical procedure. In this series, 12 patients had total pharyngolaryngectomy and 18 had total pharyngolaryngectomy and partial cervical esophagectomy. Results Postoperative pharyngocutanous fistula formation occurred in 4 patients, 2 of them with previous radiotherapy and 2 with diabetes, and the fistulae healed later. Two patients developed anastomotic strictures at the upper junction, but they had good respondses to dilatation treatment and had satisfactory oral intake. The postoperative follow-up time ranged from 8 to 56 months. Median follow-up was 18 months. One-year survival rate was 71.4% and three-year survival rate was 42.5%. Conclusions The tubed pectoralis major myocutaneous flap is a reliable procedure to reconstruct hypopharyngeal circumferential defects following resection of advanced hypopharygeal and cervical esophageal carcinoma. This method may be the optimal choice for the reconstruction of hypopharyngeal circumferential defects following resection of recurrent carcinoma. The incidence of fistula and stenosis could be kept at an acceptable level.
