title: Evaluation and management of complications or functional problems at the recipient site after esophageal and voice reconstruction with free ileocolon flap.
abstract: BACKGROUND
  The free ileocolon flap has been considered a safe method of simultaneous restoration of swallowing and voice production; however, the management of complications at the recipient site and its impact on functional outcomes are lacking in the literature.
  
  
  METHODS
  We reviewed retrospectively all consecutive patients with combined defects of the cervical esophagus and larynx reconstructed with free ileocolon flap between July 2005 and December 2009 (follow-up of ≥18 months). Patients were evaluated during the follow-up period to judge the impact of revision surgery on functional outcomes. Complications were reviewed, and the appropriate management was reported.
  
  
  RESULTS
  Swallowing function was restored in 69% of patient; functional speech function was achieved in 59%. Fourteen of the 29 patients underwent revision surgery because of complications or to improve functions at the recipient site. The mean functional improvement after revision surgery was 1.0 point on the 5-point Likert scale for speech and 1.1 point on the 7-point Likert scale for swallowing (P < .01 each).
  
  
  CONCLUSIONS
  Continuous research over the last 10 years has allowed us to refine the technique and to make the outcome more predictable.
authors.affiliation: Plastic Surgery Department, China Medical University Hospital, 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: Shih-Heng
authors.initials: SH
authors.lastname: Chen
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D003106:Colon / Q000637:transplantation; D003679:Deglutition; D004947:Esophagus / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000009:adverse effects / Q000098:blood supply; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000637:transplantation; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012086:Reoperation; D016896:Treatment Outcome; D014831:Voice