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Conference Paper: Optimizing the result of reconstruction of circumferential pharyngeal defects after tumor resection
Title | Optimizing the result of reconstruction of circumferential pharyngeal defects after tumor resection |
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Authors | |
Keywords | Medical sciences Otorhinolaryngology |
Issue Date | 2012 |
Publisher | Springer 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? |
Abstract | BACKGROUND: 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. |
Description | This 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 Identifier | http://hdl.handle.net/10722/153143 |
ISSN | 2023 Impact Factor: 1.9 2023 SCImago Journal Rankings: 0.792 |
DC Field | Value | Language |
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dc.contributor.author | Chan, JYW | en_US |
dc.contributor.author | Wei, WI | - |
dc.date.accessioned | 2012-07-16T09:58:05Z | - |
dc.date.available | 2012-07-16T09:58:05Z | - |
dc.date.issued | 2012 | en_US |
dc.identifier.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 | en_US |
dc.identifier.issn | 0937-4477 | - |
dc.identifier.uri | http://hdl.handle.net/10722/153143 | - |
dc.description | This journal issue entitled : Abstracts for the 5th European Conference on Head and Neck Oncology 18–21 April 2012 in Poznan, Poland | - |
dc.description | Oral presentations: OP35 | - |
dc.description.abstract | BACKGROUND: 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.language | eng | en_US |
dc.publisher | Springer Verlag. | - |
dc.relation.ispartof | European Archives of Oto-Rhino-Laryngology | en_US |
dc.rights | The original publication is available at www.springerlink.com | - |
dc.subject | Medical sciences | - |
dc.subject | Otorhinolaryngology | - |
dc.title | Optimizing the result of reconstruction of circumferential pharyngeal defects after tumor resection | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Chan, JYW: jywchan1@hku.hk | en_US |
dc.identifier.email | Wei, WI: hrmswwi@hku.hk | - |
dc.identifier.authority | Chan, JYW=rp01314 | en_US |
dc.identifier.hkuros | 200749 | en_US |
dc.identifier.volume | 269 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 1330 | - |
dc.identifier.epage | 1330 | - |
dc.publisher.place | Germany | - |
dc.identifier.issnl | 0937-4477 | - |