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Prevention of anastomotic leak using an advanced pectoral flap in total pharyngolaryngectomy and free jejunal reconstruction for hypopharyngeal or laryngeal carcinoma.
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- Author(s): Takahito Kondo; Masaki Nomoto; Kenji Hanyu; Yasuo Ogawa; Kiyoaki Tsukahara; Isaku Okamoto; Ray Motohashi; Yasuaki Katsube; Masanori Yatomi; Takashi Iwasawa; Naoki Yoshizawa
- Source:
Acta Oto-Laryngologica (Supplement). Oct2018, Vol. 138 Issue 10, p951-955. 5p. 6 Color Photographs, 2 Charts. - Source:
- Additional Information
- Subject Terms:
- Abstract: Background: We devised an advanced pectoral flap (APF) to prevent anastomotic leak after total pharyngolaryngectomy (TPL) and free jejunal reconstruction (FJR) in patients with hypopharyngeal or laryngeal carcinoma. The APF alleviates tension on the skin in the neck, reduces the subcutaneous dead space, and promotes adhesion between the neck skin and the anastomosis. Objective: To investigate whether an APF is effective for prevention of anastomotic leak associated with TPL/FJR. Patients and methods: Anastomotic leak was compared between APF (n=65) and non-APF groups (n=25). Patients who had received preoperative radiotherapy or undergone tracheostomy or skin infiltration requiring neck reconstruction using a pedicle flap were excluded. Results: There were significantly fewer cases of anastomotic leak in the APF group than in the non- APF group (1.5% [1/65] vs. 16.0% [4/25]; p=.02). An APF could be created bilaterally within approximately 15 minutes. Unlike a deltopectoral flap, an APF does not require a skin graft. Conclusions: The postoperative anastomotic leak rate was 1.5% in patients who underwent TPL and FJR for hypopharyngeal or laryngeal carcinoma with an APF. Significance: An APF is easily created and can reduce the incidence of anastomotic leak after TPL and FJR. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Acta Oto-Laryngologica (Supplement) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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