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Fasciocutaneous and jejunal free flaps for circumferential hypopharyngeal defect reconstruction: A 22-year multicenter cohort study.
Tonsbeek, Anthony M; Hundepool, Caroline A; Smit, Merel M; Verduijn, Pieter S; Duraku, Liron S; Sewnaik, Aniel; Wijnhoven, Bas P L; Mureau, Marc A M.
Afiliação
  • Tonsbeek AM; Department of Plastic & Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Hundepool CA; Department of Plastic & Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Smit MM; Department of Plastic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
  • Verduijn PS; Department of Plastic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
  • Duraku LS; Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
  • Sewnaik A; Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Wijnhoven BPL; Department of Oncological and Gastro-Intestinal Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Mureau MAM; Department of Plastic & Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Head Neck ; 46(6): 1351-1361, 2024 06.
Article em En | MEDLINE | ID: mdl-38294120
ABSTRACT

BACKGROUND:

It remains unclear whether a tubed fasciocutaneous or jejunal free flap (FCFF and JFF) is preferable for reconstruction of circumferential pharyngolaryngoesophageal defects.

METHODS:

All consecutive patients with circumferential pharyngolaryngoesophageal defects reconstructed with an FCFF or JFF between 2000 and 2022 were included. Outcomes of interest were rates of fistulas, strictures, and donor-site complications.

RESULTS:

In total, 112 patients were included (35 FCFFs and 77 JFFs). Fistula and stricture rates were significantly lower following JFF compared to FCFF reconstructions, with 12% versus 34% (p = 0.008) and 29% versus 49% (p = 0.04), respectively. Severe donor-site complications leading to surgical intervention or ICU admittance only occurred after JFF reconstructions (18%, p = 0.007).

CONCLUSIONS:

The high fistula and stricture rates in FCFF reconstructions and the rate of severe abdominal complications in JFF reconstructions illustrate inherent procedure-specific advantages and disadvantages. Relative pros and cons should be carefully weighed when tailoring treatments to the individual needs of patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Hipofaríngeas / Procedimentos de Cirurgia Plástica / Retalhos de Tecido Biológico / Jejuno Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Hipofaríngeas / Procedimentos de Cirurgia Plástica / Retalhos de Tecido Biológico / Jejuno Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article