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Morbidity and functional outcomes following gastro-omental free flap reconstruction of circumferential pharyngeal defects

✍ Scribed by Rajan S. Patel; Antti A. Makitie; David P. Goldstein; Patrick J. Gullane; Dale Brown; Jonathan Irish; Ralph W. Gilbert

Publisher: John Wiley and Sons
Year: 2009
Tongue: English
Weight: 532 KB
Volume: 31
Category: Article
ISSN: 1043-3074
DOI: 10.1002/hed.21016

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

Background.

In patients with extensive soft tissue fibrosis requiring circumferential pharyngeal reconstruction following definitive radiotherapy and/or chemotherapy, we take advantage of abundant omental progenitor factors in the tubed gastro‐omental free flap. This study reviews our experience with this flap.

Methods.

Review of 11 patients (median follow‐up, 2.8 years) undergoing total pharyngolaryngectomy following organ preservation protocols for recurrent squamous cell carcinoma (n = 9) and stricture (n = 2).

Results.

Operative morbidity and mortality rates were 54% and 9%, respectively. One patient died following carotid rupture. Complications included: chyle leak (18%), pharyngocutaneous fistula (9%), and late stricture (27%). Ten patients (91%) achieved oral diet, and all 7 patients (100%) considered suitable for tracheoesophageal speech rehabilitation achieved functional speech. Seven patients remain alive without disease at a median of 41 months following surgery.

Conclusions.

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