Combined pectoralis flap and gastric pull-up for pharyngeal reconstruction
✍ Scribed by Steven C. Marks; Zwi Steiger
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 228 KB
- Volume
- 19
- Category
- Article
- ISSN
- 1043-3074
No coin nor oath required. For personal study only.
✦ Synopsis
Background: The gastric transposition flap, ''gastric pull-up,'' is one of the standard techniques of reconstruction after the standard techniques for reconstructing total total laryngopharyngectomy. Under certain circumstances, this laryngopharngectomy defects. [1][3] The advantages method may provide insufficient tissue for a tension-free closure.
of this method are that it is performed in a single
In these circumstances, the surgeon could either close under stage, is reliable, and usually provides adequate tension, risking the viability of the flap and probable fistula; create tissue for the entire closure. Gastric pull-up is a pharyngostome; or recruit additional tissue. In this article, we describe the use of the pectoralis major myocutaneous flap in specifically indicated in situations where the tucombination with the gastric pull-up for reconstruction.
mor extends well down into the esophagus or
Methods: A retrospective review of three patients who underthere are skip lesions in the esophagus requiring went the procedure was performed, and a detailed description of esophagectomy. Gastric pull-up may also be fathe surgical technique is provided.
vored in many situations where donor vessels for Results: The procedure was performed in three patients, all of whom healed without wound infection or fistula.
a free jejunal transfer are not readily available Conclusions: The combination of a pectoralis flap with a gasfor anastomosis.
tric transposition is an alternative for cases in which a gastric flap
The principle disadvantage of this technique alone is insufficient. With this combination virtually any defect of is the high morbidity and mortality rate associthe upper aerodigestive tract can be successfully closed.