title: The use of a chimaeric sero-muscular flap to prevent anastomotic leakage in head and neck reconstruction with free ileocolon flap.
abstract: BACKGROUND
  In simultaneous reconstructions of cervical oesophagus and voice mechanism with free ileocolon flap, one of the most cumbersome complications is the anastomotic leakage at the junction between the colon and thoracic oesophagus.
  
  
  METHODS
  Since 2007, a chimaeric sero-muscular flap has been islanded from the distal end of the voice tube to cover the anterior aspect of the colo-oesophageal junction. Fourteen patients undergoing reconstruction of the hypopharyngo-laryngectomy defects were consecutively treated with the sero-muscular flap. The leakage rate was compared with a group of 15 patients who were reconstructed with a free ileocolon flap prior to the adoption of the new procedure.
  
  
  RESULTS
  All flaps survived completely. Swallowing function (scores 5-7), was restored in 69% of the patients. Speech function was restored (scores 4-5) in 59% of the patients. In the treatment group, only one patient suffered from anastomotic leakage compared to four patients in the control group.
  
  
  CONCLUSIONS
  The chimaeric sero-muscular flap can secure the colo-oesophageal junction, improving the healing process and preventing delays in the administration of adjuvant therapy.
authors.affiliation: Plastic Surgery Department, China Medical University and China Medical University Hospital, 2, Yuh-Der Road, Taichung, Taiwan.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perrone
authors.forename: Bahar Bassiri
authors.initials: BB
authors.lastname: Gharb
authors.forename: Antonio
authors.initials: A
authors.lastname: Rampazzo
authors.forename: Quan Dinh
authors.initials: QD
authors.lastname: Ngo
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000517:prevention & control*; D015331:Cohort Studies; D003106:Colon / Q000601:surgery; D003679:Deglutition / Q000502:physiology; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D013524:Surgical Flaps; D013624:Taiwan; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D018183:Transplantation Chimera; D016896:Treatment Outcome; D014945:Wound Healing