Closure of esophageal defects with muscle flaps.
OBJECTIVE
To determine the feasibility and reliability of muscle flaps as a sole means of closure of severe esophageal defects.


METHODS
Retrospective case series of patients with esophageal defects closed with muscle flaps. Mean follow-up was 6 years.


METHODS
A university hospital and a tertiary care, university-affiliated, private hospital.


METHODS
Fourteen patients with esophageal defects that could not be closed by standard suture techniques or failed to close with observation alone.


METHODS
Survival, continued esophageal leakage, restoration of esophageal continuity, and long-term esophageal function.


RESULTS
There was one operative death and one delayed death, both unrelated to the esophageal injury. There were five early leaks that healed promptly. Esophageal continuity was restored in all patients. Long-term esophageal function has been excellent.


CONCLUSIONS
The use of primary muscle repair for esophageal defects not amenable to standard closure techniques provides an excellent means of closing esophageal wounds and restoring esophageal continuity. This option appears to be preferable to other more destructive options in managing this serious problem.
Richardson
J D
JD
Department of Surgery, University of Louisville, School of Medicine. Ky.
Tobin
G R
GR
D000293:Adolescent; D000328:Adult; D000368:Aged; D004939:Esophageal Perforation / Q000209:etiology / Q000601:surgery*; D004947:Esophagus / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012421:Rupture; D012422:Rupture, Spontaneous; D013524:Surgical Flaps / Q000379:methods*; D013997:Time Factors; D014948:Wounds, Gunshot / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000601:surgery*