title: A "watch window" technique for monitoring buried free jejunum flaps during circumferential pharyngolaryngectomy reconstruction.
abstract: The free jejunum flap approach is the optimal option for circumferential pharyngolaryngectomy reconstruction. In this study, we designed a "watch window" for monitoring buried free jejunum flaps, thereby allowing us to assess graft viability. From 2007 to 2011, 14 patients with hypopharyngeal cancer underwent circumferential pharyngolaryngectomy that was reconstructed using a free jejunum flap at the Sun Yat-sen University Cancer Centre. During the closing of the neck incision, a "watch window" was designed for postoperative monitoring. Two patients experienced thrombosis of the pedicle. One was detected early and successfully rescued by removal of the thrombosis, the other one managed with a second free jejunum flap. The success rate of the buried flaps was 92.9%. No pharyngocutaneous fistulas or strictures occurred. All patients eventually resumed oral feeding and swallowing. The "watch window" technique for monitoring buried free jejunum flaps is simple, reliable and useful for finding vascular problems. Level of evidence Case series.
authors: State Key Laboratory of Oncology in South China, Department of Head and Neck Surgery, Cancer Centre, Sun Yat-Sen University, Guangzhou, 510060 Guangdong, People's Republic of China.
authors: Quan
authors: Q
authors: Li
authors: Xin-Rui
authors: XR
authors: Zhang
authors: Xue-Kui
authors: XK
authors: Liu
authors: Zhi-Gang
authors: ZG
authors: Zhang
authors: Wei-Wei
authors: WW
authors: Liu
authors: Hao
authors: H
authors: Li
authors: Zhu-Ming
authors: ZM
authors: Guo
mesh_terms: D061345:Early Medical Intervention / Q000379:methods; D005260:Female; D006085:Graft Survival; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012039:Regional Blood Flow; D012086:Reoperation / Q000379:methods; D015203:Reproducibility of Results; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D058106:Wound Closure Techniques