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http://dx.doi.org/10.7181/acfs.2015.16.3.105

Reconstructive Trends in Post-Ablation Patients with Esophagus and Hypopharynx Defect  

Ki, Sae Hwi (Department of Plastic Surgery, Inha University School of Medicine)
Choi, Jong Hwan (Department of Plastic Surgery, Inha University Hospital)
Sim, Seung Hyun (Inha University Hospital)
Publication Information
Archives of Craniofacial Surgery / v.16, no.3, 2015 , pp. 105-113 More about this Journal
Abstract
The main challenge in pharyngoesophageal reconstruction is the restoration of swallow and speech functions. The aim of this paper is to review the reconstructive options and associated complications for patients with head and neck cancer. A literature review was performed for pharynoesophagus reconstruction after ablative surgery of head and neck cancer for studies published between January 1980 to July 2015 and listed in the PubMed database. Search queries were made using a combination of 'esophagus' and 'free flap', 'microsurgical', or 'free tissue transfer'. The search query resulted in 123 studies, of which 33 studies were full text publications that met inclusion criteria. Further review into the reference of these 33 studies resulted in 15 additional studies to be included. The pharyngoesophagus reconstruction should be individualized for each patient and clinical context. Fasciocutaneous free flap and pedicled flap are effective for partial phayngoesophageal defect. Fasciocutaneous free flap and jejunal free flap are effective for circumferential defect. Pedicled flaps remain a safe option in the context of high surgical risk patients, presence of fistula. Among free flaps, anterolateral thigh free flap and jejunal free flap were associated with superior outcomes, when compared with radial forearm free flap. Speech function is reported to be better for the fasciocutaneous free flap than for the jejunal free flap.
Keywords
Esophagus; Reconstruction; Free tissue transfer; Cancer; Review;
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1 Hayden RE, Kirby SD, Deschler DG. Technical modifications of the latissimus dorsi pedicled flap to increase versatility and viability. Laryngoscope 2000;110:352-7.   DOI
2 Amin AA, Rifaat M, Ellabban MA, Zedan M, Kamel M, Bassiouny M. Transaxillary thoracodorsal artery perforator flap: a versatile new technique for hypopharyngeal reconstruction. J Reconstr Microsurg 2014;30:397-404.   DOI
3 Heitmann C, Guerra A, Metzinger SW, Levin LS, Allen RJ. The thoracodorsal artery perforator flap: anatomic basis and clinical application. Ann Plast Surg 2003;51:23-9.   DOI
4 Hamdi M, Van Landuyt K, Hijjawi JB, Roche N, Blondeel P, Monstrey S. Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients. Plast Reconstr Surg 2008;121:1632-41.   DOI
5 Chiu ES, Liu PH, Friedlander PL. Supraclavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and outcomes. Plast Reconstr Surg 2009;124:115-23.   DOI
6 Kokot N, Mazhar K, Reder LS, Peng GL, Sinha UK. The supraclavicular artery island flap in head and neck reconstruction: applications and limitations. JAMA Otolaryngol Head Neck Surg 2013;139:1247-55.   DOI
7 Pallua N, Machens HG, Rennekampff O, Becker M, Berger A. The fasciocutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures. Plast Reconstr Surg 1997;99:1878-84.   DOI
8 Piazza C, Taglietti V, Nicolai P. Reconstructive options after total laryngectomy with subtotal or circumferential hypopharyngectomy and cervical esophagectomy. Curr Opin Otolaryngol Head Neck Surg 2012;20:77-88.   DOI
9 Perrone F, Nitto A, Tang YB, Chen SH, Chen HC. Three uses of an extra length of jejunum in pharyngo-oesophageal reconstruction with free jejunal flap. J Plast Reconstr Aesthet Surg 2013;66:16-22.   DOI
10 Leu YS, Huang CM, Yang CC, Hsiao HT, Chang YC. Functional outcome following free ileocolic flap in total pharyngolaryngectomy. Acta Otolaryngol 2008;128:702-5.   DOI
11 Perez-Smith D, Wagels M, Theile DR. Jejunal free flap reconstruction of the pharyngolaryngectomy defect: 368 consecutive cases. J Plast Reconstr Aesthet Surg 2013;66:9-15.   DOI
12 Kim Evans KF, Mardini S, Salgado CJ, Chen HC. Esophagus and hypopharyngeal reconstruction. Semin Plast Surg 2010;24:219-26.   DOI
13 Kim EK, Evangelista M, Evans GR. Use of free tissue transfers in head and neck reconstruction. J Craniofac Surg 2008;19:1577-82.   DOI
14 Richmon JD, Brumund KT. Reconstruction of the hypopharynx: current trends. Curr Opin Otolaryngol Head Neck Surg 2007;15:208-12.   DOI
15 Nagel TH, Hayden RE. Advantages and limitations of free and pedicled flaps in reconstruction of pharyngoesophageal defects. Curr Opin Otolaryngol Head Neck Surg 2014;22:407-13.   DOI
16 Elfeky AE, Nasr WF, Khazbak A, Abdelrahman MS, Allam ZA, Gareer WY, et al. Hypopharyngeal reconstruction: a comparison of three alternatives. Eur Arch Otorhinolaryngol 2015;272:3045-50.   DOI
17 Li KK, Salibian AH, Allison GR, Krugman ME, Armstrong W, Wong B, et al. Pharyngoesophageal reconstruction with the ulnar forearm flap. Arch Otolaryngol Head Neck Surg 1998;124:1146-51.   DOI
18 Rand RP, Lin EY, Wood DE. Total esophageal reconstruction using a tubed parascapular free flap. Ann Thorac Surg 2001;72:267-70.   DOI
19 Yu P, Lewin JS, Reece GP, Robb GL. Comparison of clinical and functional outcomes and hospital costs following pharyngoesophageal reconstruction with the anterolateral thigh free flap versus the jejunal flap. Plast Reconstr Surg 2006;117:968-74.   DOI
20 Varvares MA, Cheney ML, Gliklich RE, Boyd JM, Goldsmith T, Lazor J, et al. Use of the radial forearm fasciocutaneous free flap and montgomery salivary bypass tube for pharyngoesophageal reconstruction. Head Neck 2000;22:463-8.   DOI
21 Yang G, Chen B, Gao Y. Forearm free skin flap transplantation. Nat Med J China 1981;61:139-42.
22 Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984;37:149-59.   DOI
23 Nakatsuka T, Harii K, Asato H, Ebihara S, Yoshizumi T, Saikawa M. Comparative evaluation in pharyngo-oesophageal reconstruction: radial forearm flap compared with jejunal flap: a 10-year experience. Scand J Plast Reconstr Surg Hand Surg 1998;32:307-10.   DOI
24 Ariyan S. The pectoralis major myocutaneous flap: a versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 1979;63:73-81.   DOI
25 Bakamjian VY. A two-stage method for pharyngoesophageal reconstruction with a primary pectoral skin flap. Plast Reconstr Surg 1965; 36:173-84.   DOI
26 Welkoborsky HJ, Deichmuller C, Bauer L, Hinni ML. Reconstruction of large pharyngeal defects with microvascular free flaps and myocutaneous pedicled flaps. Curr Opin Otolaryngol Head Neck Surg 2013;21:318-27.
27 Noland SS, Ingraham JM, Lee GK. The sternocleidomastoid myocutaneous "patch esophagoplasty" for cervical esophageal stricture. Microsurgery 2011;31:318-22.   DOI
28 Burke MS, Kaplan SE, Kaplowitz LJ, Lotempio MM, Hicks WL Jr, Rigual NR, et al. Pectoralis major myocutaneous flap for reconstruction of circumferential pharyngeal defects. Ann Plast Surg 2013;71:649-51.   DOI
29 Montemari G, Rocco A, Galla S, Damiani V, Bellocchi G. Hypopharynx reconstruction with pectoralis major myofascial flap: our experience in 45 cases. Acta Otorhinolaryngol Ital 2012;32:93-7.
30 Dubsky PC, Stift A, Rath T, Kornfehl J. Salvage surgery for recurrent carcinoma of the hypopharynx and reconstruction using jejunal free tissue transfer and pectoralis major muscle pedicled flap. Arch Otolaryngol Head Neck Surg 2007;133:551-5.   DOI
31 Demirtas Y, Yagmur C, Kelahmetoglu O, Demir A, Guneren E. Transaxillary-subclavian transfer of pedicled latissimus dorsi musculocutaneous f lap to head and neck region. J Craniofac Surg 2010;21:771-5.   DOI
32 Righini CA, Bettega G, Lequeux T, Chaffanjeon P, Lebeau J, Reyt E. Use of tubed gastro-omental free flap for hypopharynx and cervical esophagus reconstruction after total laryngo-pharyngectomy. Eur Arch Otorhinolaryngol 2005;262:362-7.   DOI
33 Cho BC, Shin DP, Byun JS, Park JW, Baik BS. Monitoring flap for buried free tissue transfer: its importance and reliability. Plast Reconstr Surg 2002;110:1249-58.   DOI
34 Selber JC, Xue A, Liu J, Hanasono MM, Skoracki RJ, Chang EI, et al. Pharyngoesophageal reconstruction outcomes following 349 cases. J Reconstr Microsurg 2014;30:641-54.   DOI
35 Seidenberg B, Rosenak SS, Hurwitt ES, Som ML. Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment. Ann Surg 1959;149:162-71.   DOI
36 Lorenz RR, Alam DS. The increasing use of enteral flaps in reconstruction for the upper aerodigestive tract. Curr Opin Otolaryngol Head Neck Surg 2003;11:230-5.   DOI
37 Fabian RL. Reconstruction of the laryngopharynx and cervical esophagus. Laryngoscope 1984;94:1334-50.
38 Jegoux F, Ferron C, Malard O, Espitalier F, Beauvillain de montreuil C. Reconstruction of circumferential pharyngolaryngectomy using a 'horseshoe-shaped' pectoralis major myocutaneous flap. J Laryngol Otol 2007;121:483-8.
39 Pierrel C, Bodin F, Schultz P, Dupret-Bories A. Semi-free forearm flap for pharyngeal-esophageal reconstruction after radiation therapy. Eur Ann Otorhinolaryngol Head Neck Dis 2015;132:101-3.   DOI
40 Komorowska-Timek E, Lee GK. Tube-in-a-tube anterolateral thigh flap for reconstruction of a complex esophageal and anterior neck defect. Ann Plast Surg 2014;72:64-6.   DOI
41 Laing TA, Van Dam H, Rakshit K, Dilkes M, Ghufoor K, Patel H. Free jejunum reconstruction of upper esophageal defects. Microsurgery 2013;33:3-8.   DOI
42 Dodd AR, Goodnight JE, Pu LL. Successful management of cervicoesophageal anastomosis leak after microsurgical esophageal reconstruction: a case report and review of the literature. Ann Plast Surg 2010;65:110-4.   DOI
43 Gaur P, Blackmon SH. Jejunal graft conduits after esophagectomy. J Thorac Dis 2014;6 Suppl 3:S333-40.
44 Hanson RP, Chow TK, Feehan E, Eadie PA, Timon CT, Keogh S. Analysis of functional results and quality of life following free jejunal flaps for reconstruction after upper aerodigestive neoplastic resection: the St James's experience. J Plast Reconstr Aesthet Surg 2007;60:577-82.   DOI
45 Moradi P, Glass GE, Atherton DD, Eccles S, Coffey M, Majithia A, et al. Reconstruction of pharyngolaryngectomy defects using the jejunal free flap: a 10-year experience from a single reconstructive center. Plast Reconstr Surg 2010;126:1960-6.   DOI
46 Schneider DS, Gross ND, Sheppard BC, Wax MK. Reconstruction of the jejunoesophageal anastomosis with a circular mechanical stapler in total laryngopharyngectomy defects. Head Neck 2012;34:721-6.   DOI
47 Chang SY, Chen HC, Tang YB, Tan BK, Wei FC. Prefabrication of jejunum for challenging reconstruction of cervical esophagus. Plast Reconstr Surg 1999;104:2112-5.   DOI
48 Talbot SG, Cordeiro PG. Inverted, stapled J-pouch free jejunal transfer for reconstruction of the pharynx and esophagus. J Surg Oncol 2007;95:663-9.   DOI