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Conference Paper: Optimizing the result of reconstruction of circumferential pharyngeal defects after tumor resection

TitleOptimizing the result of reconstruction of circumferential pharyngeal defects after tumor resection
Authors
KeywordsMedical sciences
Otorhinolaryngology
Issue Date2012
PublisherSpringer Verlag.
Citation
The 5th European Conference On Head & Neck Oncology (ECHNO 2012), Poznan, Poland, 19-21 April 2012. In European Archives of Oto-Rhino-Laryngology, 2012, v. 269 n. 4, p. 1330, abstract no, OP35 How to Cite?
AbstractBACKGROUND: Reconstruction of circumferential hypopharyngeal defects is often challenging. The aim of the study is to examine the result of our experience and to formulate improved management guidelines. METHODS: Between 1980 and 2009, all patients who had circumferential pharyngectomy were recruited. Data were recorded prospectively for analysis. RESULTS: Two hundred and two patients were recruited. Majority had primary tumour in the hypopharynx (n = 165), and the remaining patients had recurrent laryngeal carcinoma. Radiotherapy was given pre-operatively in 72 patients and post-operatively in 108 patients. Pectoralis major (PM) flap was used in 92 (45.5%) patients, free anterolateral thigh (ALT) flap in 24 (11.9%) patients and free jejuna flap in 86 (42.6%) patients. Early fistula rate was 23.9% in the PM flap group, 12.5% in the ALT group and 4.6% in the jejunum group. Late anastomotic stricture rate was 27.2% in the PM flap group, 12.5% in free ALT group and 2.3% in the jejunum group. Early fistula formation significantly increased the risk of subsequent anastomotic stricture (p = 0.023). In patients with no stricture, 61.9% of those in the jejunal group were able to resume solid diet, compared to 35.8 and 38.1% in the PM and ALT group. After PM flap harvesting, 34.8% of the chest wall defects could not be closed primarily, which were best repaired using the lateral thoracic flap. The donor site morbidity of ALT and jejunal flap was low. CONCLUSIONS: In suitable patients, free jejunal flap reconstruction of circumferential pharyngectomy defects achieves the best functional outcome with minimal donor site morbidity.
DescriptionThis journal issue entitled : Abstracts for the 5th European Conference on Head and Neck Oncology 18–21 April 2012 in Poznan, Poland
Oral presentations: OP35
Persistent Identifierhttp://hdl.handle.net/10722/153143
ISSN
2015 Impact Factor: 1.627
2015 SCImago Journal Rankings: 0.755

 

DC FieldValueLanguage
dc.contributor.authorChan, JYWen_US
dc.contributor.authorWei, WI-
dc.date.accessioned2012-07-16T09:58:05Z-
dc.date.available2012-07-16T09:58:05Z-
dc.date.issued2012en_US
dc.identifier.citationThe 5th European Conference On Head & Neck Oncology (ECHNO 2012), Poznan, Poland, 19-21 April 2012. In European Archives of Oto-Rhino-Laryngology, 2012, v. 269 n. 4, p. 1330, abstract no, OP35en_US
dc.identifier.issn0937-4477-
dc.identifier.urihttp://hdl.handle.net/10722/153143-
dc.descriptionThis journal issue entitled : Abstracts for the 5th European Conference on Head and Neck Oncology 18–21 April 2012 in Poznan, Poland-
dc.descriptionOral presentations: OP35-
dc.description.abstractBACKGROUND: Reconstruction of circumferential hypopharyngeal defects is often challenging. The aim of the study is to examine the result of our experience and to formulate improved management guidelines. METHODS: Between 1980 and 2009, all patients who had circumferential pharyngectomy were recruited. Data were recorded prospectively for analysis. RESULTS: Two hundred and two patients were recruited. Majority had primary tumour in the hypopharynx (n = 165), and the remaining patients had recurrent laryngeal carcinoma. Radiotherapy was given pre-operatively in 72 patients and post-operatively in 108 patients. Pectoralis major (PM) flap was used in 92 (45.5%) patients, free anterolateral thigh (ALT) flap in 24 (11.9%) patients and free jejuna flap in 86 (42.6%) patients. Early fistula rate was 23.9% in the PM flap group, 12.5% in the ALT group and 4.6% in the jejunum group. Late anastomotic stricture rate was 27.2% in the PM flap group, 12.5% in free ALT group and 2.3% in the jejunum group. Early fistula formation significantly increased the risk of subsequent anastomotic stricture (p = 0.023). In patients with no stricture, 61.9% of those in the jejunal group were able to resume solid diet, compared to 35.8 and 38.1% in the PM and ALT group. After PM flap harvesting, 34.8% of the chest wall defects could not be closed primarily, which were best repaired using the lateral thoracic flap. The donor site morbidity of ALT and jejunal flap was low. CONCLUSIONS: In suitable patients, free jejunal flap reconstruction of circumferential pharyngectomy defects achieves the best functional outcome with minimal donor site morbidity.-
dc.languageengen_US
dc.publisherSpringer Verlag.-
dc.relation.ispartofEuropean Archives of Oto-Rhino-Laryngologyen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectMedical sciences-
dc.subjectOtorhinolaryngology-
dc.titleOptimizing the result of reconstruction of circumferential pharyngeal defects after tumor resectionen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, JYW: jywchan1@hku.hken_US
dc.identifier.emailWei, WI: hrmswwi@hku.hk-
dc.identifier.authorityChan, JYW=rp01314en_US
dc.identifier.hkuros200749en_US
dc.identifier.volume269-
dc.identifier.issue4-
dc.identifier.spage1330-
dc.identifier.epage1330-
dc.publisher.placeGermany-

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