Thirty‐five years of single surgeon experience in the reconstruction of esophagus and voice with free ileocolon flap following total pharyngolaryngectomy

Thirty‐five years of single surgeon experience in the reconstruction of esophagus and voice... INTRODUCTIONFree jejunal flap transfer was first performed in 1957 and reported 2 years later by Seidenberg et al Despite being the first free flap performed in the history of microsurgery, the use of free intestinal flaps has not yet gained widespread popularity. There are several major reasons behind this: (i) The harvest of a free intestinal flap requires either a plastic surgeon facile with intraabdominal dissection or general surgeons who are not always available; (ii) The free intestinal flap can tolerate only short ischemia time; therefore a well‐trained microsurgeon able to achieve prompt flap revascularization is required; (iii) The potential complications of laparotomy, such as intestinal adhesion and internal herniation, can potentially be quite morbid and even life threatening. On the contrary, the donor site complications of a skin flap (wound infection, loss of skin graft) are not as severe and are much easier to manage; (iv) At the recipient site, the management of a free intestinal flap is not as simple as a skin flap. The high bacterial count of the intestinal flaps may lead to infection, if there is a seroma or hematoma at the recipient site. The infection may compromise the microvascular anastomoses.For reconstruction of total http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Surgical Oncology Wiley

Thirty‐five years of single surgeon experience in the reconstruction of esophagus and voice with free ileocolon flap following total pharyngolaryngectomy

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0022-4790
eISSN
1096-9098
D.O.I.
10.1002/jso.24864
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONFree jejunal flap transfer was first performed in 1957 and reported 2 years later by Seidenberg et al Despite being the first free flap performed in the history of microsurgery, the use of free intestinal flaps has not yet gained widespread popularity. There are several major reasons behind this: (i) The harvest of a free intestinal flap requires either a plastic surgeon facile with intraabdominal dissection or general surgeons who are not always available; (ii) The free intestinal flap can tolerate only short ischemia time; therefore a well‐trained microsurgeon able to achieve prompt flap revascularization is required; (iii) The potential complications of laparotomy, such as intestinal adhesion and internal herniation, can potentially be quite morbid and even life threatening. On the contrary, the donor site complications of a skin flap (wound infection, loss of skin graft) are not as severe and are much easier to manage; (iv) At the recipient site, the management of a free intestinal flap is not as simple as a skin flap. The high bacterial count of the intestinal flaps may lead to infection, if there is a seroma or hematoma at the recipient site. The infection may compromise the microvascular anastomoses.For reconstruction of total

Journal

Journal of Surgical OncologyWiley

Published: Jan 1, 2018

Keywords: ; ; ;

References

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