title: Free flaps for type III complex pharyngoesophageal defects after enlarged ablative surgery for advanced cancer of larynx and hypopharynx.
abstract: Free tissue transfer has become a useful technique for reconstruction of type III complex pharyngoesophageal defects after enlarged laryngectomy and partial or total pharyngoesophageal resection. We present a retrospective analysis of our experience with 36 patients who received free flaps for reconstruction of complex pharyngoesophageal defects associated with skin and soft-tissue defects. Free fasciocutaneous flaps and jejunum combined with a deltopectoral flap and musculocutaneous pectoralis major flap, gastro-omental flap, and combined latissimus dorsi musculocutaneous and cutaneous scapular flaps were used for reconstruction. Adjuvant therapy included preoperative or postoperative radiotherapy. Free flap failure occurred in 2 of 36 patients. Twenty-eight patients had good swallowing function. Better results with fewer complications in reconstruction of type III complex pharyngoesophageal defects were obtained with the use of a combined latissimus dorsi and scapular flap.
authors.affiliation: Division of Plastic Surgery, Hospital for Plastic, Reconstructive Surgery and Burns, Bucharest Medical University, Bucharest, Romania. nantohi@rol.ro
authors.forename: Nicolae
authors.initials: N
authors.lastname: Antohi
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Tibirna
authors.forename: Ilie
authors.initials: I
authors.lastname: Suharski
authors.forename: Anatol
authors.initials: A
authors.lastname: Bejan
authors.forename: Sergiu
authors.initials: S
authors.lastname: Marina
authors.forename: Vadim
authors.initials: V
authors.lastname: Pogonet
authors.forename: Vitalie
authors.initials: V
authors.lastname: Stan
mesh_terms: D000465:Algorithms; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*