Tubed pectoralis major musculocutaneous flaps for cervical esophageal replacement.
Five patients undergoing laryngopharyngectomy and cervical esophagectomy for cancer were reconstructed using a tubed pectoralis major musculocutaneous flap for esophageal replacement. One patient had no complications, 2 had pinpoint fistulas with rapid healing, a fourth died of a myocardial infarction, and the fifth had a partial breakdown requiring secondary flap closure. This flap is safe, reliable, and easy to rotate and tube on itself; use of the tubed pectoralis major musculocutaneous flap obviates the necessity for laparotomy for colon interposition, gastric pull-through, or jejunal free grafts. In addition, microvascular anastomoses are not required. Therefore, it is recommended as an excellent means of replacing the cervical esophagus and should be considered a method of choice in debilitated patients.
D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications; D013524:Surgical Flaps