An objective comparison regarding rate of fistula and stricture among anterolateral thigh, radial forearm, and jejunal free tissue transfers in circumferential pharyngo-esophageal reconstruction

Ngian Chye Tan, Pao Yuan Lin, Pao Jen Kuo, Yun Ta Tsai, Yen Chou Chen, Khanh Thien Nguyen, Yur Ren Kuo*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

37 Scopus citations

Abstract

Background The three commonly used free flaps for circumferential pharyngeal reconstruction after total pharyngo-laryngectomy are the radial forearm flap (RFF), the anterolateral thigh (ALT) flap, and the jejunum flap. This study was to objectively compare three different flaps for pharyngeal reconstruction during the past 10 years. Stricture and fistula were assessed using esophagogram and esophagoscopy. Methods Forty-five patients with pharyngeal reconstructions had esophagram and esophagoscopy done postoperatively to assess for strictures and fistulas. These patients were divided into three groups based on pharyngeal reconstruction by ALT, RFF, and jejunal flaps. From the results of the esophagogram and esophagoscope, the presence of a fistula or stricture was compared and analyzed. Results There was only one ALT flap failure. The rate of fistula was 33%, 50%, and 30% in the ALT, RFF, and jejunal flap group respectively. The fistula rate revealed no significant difference between ALT, RFF, jejunal flap groups (P = 0.63). The rate of stricture was 38.1%, 57.1%, and 0% in the ALT, RFA, jejunal flap groups respectively. The stricture rate in jejunal flap group revealed significant decrease (P = 0.0093). Conclusion Jejunal flap has a significantly lower rate of stricture for reconstruction of circumferential pharyngeal defects when compared with RFF or ALT flaps.

Original languageEnglish
Pages (from-to)345-349
Number of pages5
JournalMicrosurgery
Volume35
Issue number5
DOIs
StatePublished - 01 07 2015

Bibliographical note

Publisher Copyright:
© 2014 Wiley Periodicals, Inc. Microsurgery 35:345-349, 2015. © 2014 Wiley Periodicals, Inc.

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