Pharyngocutaneous fistulas: management with one-stage flap reconstruction.
After total laryngectomy, postoperative pharyngocutaneous fistula still constitutes a most troublesome and challenging problem. We present 9 cases of postoperative fistulas managed by one-stage flap reconstruction. Possible contributing factors related to earlier management or medical status are identified. When the posterior pharyngeal wall was intact in a large pharyngocutaneous fistula, 4 pectoralis major and 2 latissimus dorsi double island musculocutaneous flaps were used. Autogenous jejunal free grafts were used in 3 patients when circumferential reconstruction was required. The cervical esophagus was successfully reconstructed, facilitating swallowing function, in a one-stage procedure in each patient.
Robb
G L
GL
Department of Surgery, University of Pittsburgh School of Medicine, PA 15261.
Swartz
W M
WM
D000368:Aged; D005402:Fistula / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000379:methods*