The Wookey flap revisited.
BACKGROUND
Complete circumferential pharyngoesophageal reconstruction has undergone remarkable changes and developments during the last three decades. Gastric transposition and microvascular techniques are the standards of care. However, in cases of failure, or where other factors such as severe comorbidities prevent the use of microvascular techniques, reconstruction with local flaps provide a reliable option. We have used the Wookey flap technique in six patients with complete circumferential loss of the pharynx and upper esophagus. To make the procedure more reliable, we added a "delay" stage.


METHODS
Retrospective review of charts of six Wookey-type reconstructions of the pharynx and upper esophagus done in our department at SUNY-HSC, Brooklyn, and The Long Island College Hospital.


RESULTS
Five of the six patients had successful reconstruction of complete circumferential pharyngoesophageal resection. All five resumed oral alimentation. The flap failed in one patient.


CONCLUSIONS
The Wookey flap may still provide surgeons with a "last resort" reconstructive option after complete, circumferential pharyngoesophageal resection.
Sundaram
Krishnamurthi
K
Department of Otolaryngology, State University of New York-Health Science Center, Brooklyn, New York, and The Long Island College Hospital, Brooklyn, New York, USA.
Har-El
Gady
G
D000368:Aged; D000075202:Contraindications; D004938:Esophageal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D010614:Pharynx / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps / Q000009:adverse effects