Reconstruction of circumferential pharyngoesophageal defects with laryngotracheal flap and pectoralis major myocutaneous flap

Head Neck. 2002 Oct;24(10):933-9. doi: 10.1002/hed.10149.

Abstract

Background: Hypopharyngeal cancer often presents at an advanced stage. Radical surgery has played an important role in the treatment of these cases; however, it always results in a large, or even a circumferential, defect of the pharyngoesophageal segment (PES) that causes some difficulties during reconstruction.

Materials and methods: Twelve patients with advanced hypopharyngeal cancer and cervical esophageal invasion received surgery resulting in a circumferential defect of PES, which was reconstructed with the contralateral unaffected laryngotracheal flap and a patch-on pectoralis major myocutaneous flap (PMMCF).

Results: The operation time of this method was shorter compared with free flap reconstruction. Only two minor complications and no pharyngocutaneous fistulas were found postoperatively. Nine patients can resume a regular diet. During the follow-up period (median, 38 months), there were no local recurrences and only one contralateral neck recurrence.

Conclusions: The preliminary result shows this technique is a simple and effective method with low morbidity and satisfactory oncologic and functional results.

MeSH terms

  • Aged
  • Esophagoplasty
  • Humans
  • Hypopharyngeal Neoplasms / diagnostic imaging
  • Hypopharyngeal Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Pharyngectomy
  • Pharynx / surgery*
  • Plastic Surgery Procedures
  • Radiography
  • Surgical Flaps*