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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2014

Open Access 01-12-2014 | Research

Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases

Authors: Adel Denewer, Ashraf Khater, Mohamed T Hafez, Osama Hussein, Sameh Roshdy, Fayez Shahatto, Waleed Elnahas, Sherif Kotb, Khaled Mowafy

Published in: World Journal of Surgical Oncology | Issue 1/2014

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Abstract

Background

The aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma.

Methods

One hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment.

Results

Pectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases. Mean hospital stay was 12 days. Mortality rate was 10.6% and morbidity rate was 31.7%. Total flap failure occurred in 3 cases of free flap and one case of pectoralis flap. There were 23 cases of early fistula. Late stricture occurred in 19 cases, being highest with myocutaneous flap (early fistula 12/50 and late stricture 13/50).

Conclusion

Free jejunal flap was the flap of choice for reconstruction when the safety margin is still above the clavicle. In cases with added esophagectomy, we recommend gastric tube as a method of choice for reconstruction.
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Metadata
Title
Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases
Authors
Adel Denewer
Ashraf Khater
Mohamed T Hafez
Osama Hussein
Sameh Roshdy
Fayez Shahatto
Waleed Elnahas
Sherif Kotb
Khaled Mowafy
Publication date
01-12-2014
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-12-182

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