Ileocolic free flap for voice and swallowing rehabilitation after pharyngolaryngo-esophagectomy: a preliminary report

Ileocolic free flap for voice and swallowing rehabilitation after pharyngolaryngo-esophagectomy:... The usual approach for patients with advanced hypopharyngeal cancer is a multimodal treatment with surgical resection and radiation therapy. A circular pharyngolaryngoesophagectomy is mandatory in cases with advanced disease, even if it extends above the upper esophageal sphincter, followed by an immediate reconstruction. A microsurgical reconstructive technique is advised, based on Kawahara’s technique, using an ileocolic free flap as a single stage procedure for voice and swallowing rehabilitation. A total of four patients with advanced squamous cell carcinoma of the oropharynx was submitted to surgery. After pharyngolaryngoesophagectomy, the ileocolic complex was transposed and revascularized in the cervical field; the digestive tract restoration was performed with the cecum and ascending colon, while the last ileal loop was anastomosed to the cervical trachea. The continence mechanism of the ileocecal valve was used to protect the airways from inhalation of food and saliva and to obtain a monotonic phonation. A tracheal stoma was maintained to permit satisfactory breathing. All patients underwent this procedure successfully, with recovery of swallowing function and vocal performance within a short time, varying from 18 to 38 days. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Ileocolic free flap for voice and swallowing rehabilitation after pharyngolaryngo-esophagectomy: a preliminary report

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Publisher
Springer Journals
Copyright
Copyright © 2000 by Springer-Verlag Berlin Heidelberg
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s002380050001
Publisher site
See Article on Publisher Site

Abstract

The usual approach for patients with advanced hypopharyngeal cancer is a multimodal treatment with surgical resection and radiation therapy. A circular pharyngolaryngoesophagectomy is mandatory in cases with advanced disease, even if it extends above the upper esophageal sphincter, followed by an immediate reconstruction. A microsurgical reconstructive technique is advised, based on Kawahara’s technique, using an ileocolic free flap as a single stage procedure for voice and swallowing rehabilitation. A total of four patients with advanced squamous cell carcinoma of the oropharynx was submitted to surgery. After pharyngolaryngoesophagectomy, the ileocolic complex was transposed and revascularized in the cervical field; the digestive tract restoration was performed with the cecum and ascending colon, while the last ileal loop was anastomosed to the cervical trachea. The continence mechanism of the ileocecal valve was used to protect the airways from inhalation of food and saliva and to obtain a monotonic phonation. A tracheal stoma was maintained to permit satisfactory breathing. All patients underwent this procedure successfully, with recovery of swallowing function and vocal performance within a short time, varying from 18 to 38 days.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Jul 17, 2000

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