Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube.
BACKGROUND
This study reports our experience with fasciocutaneous reconstruction of circumferential pharyngoesophageal defects using an anterolateral thigh flap wrapped around a salivary bypass tube.


METHODS
The charts of 14 patients were reviewed. All patients who had reconstruction of a pharyngoesophageal defect using an anterolateral thigh flap with a salivary bypass tube between 2001 and 2005 were included.


RESULTS
There were 10 men and 4 women (mean age, 61 years). There were no fistulae reported, and the stricture rate was 14%. Eleven patients achieved oral diet sufficient to have the gastrostomy or jejunal tube removed. The patients who had tracheoesophageal puncture for voice developed functional speech. There were no flap losses. However, problems with salivary tube migration in the early cases have led to technique refinement.


CONCLUSIONS
The low complication rates and the excellent functional outcomes make the anterolateral thigh flap in combination with a salivary bypass tube a viable option for reconstruction of these difficult defects.
Murray
Dylan J
DJ
Division of Plastic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Gilbert
Ralph W
RW
Vesely
Martin J J
MJ
Novak
Christine B
CB
Zaitlin-Gencher
Sheryl
S
Clark
Jonathan R
JR
Gullane
Patrick J
PJ
Neligan
Peter C
PC
D000368:Aged; D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002296:Carcinosarcoma / Q000601:surgery; D016629:Esophagectomy; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D007440:Intubation; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery; D010611:Pharyngectomy; D010614:Pharynx / Q000601:surgery*; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012463:Saliva; D013524:Surgical Flaps; D016896:Treatment Outcome