Modified distal anastomosis between colon and thoracic esophagus for hypopharynx reconstruction using free colon flap: A comparison study

Ram M. Chilgar, Fabio Nicoli, Bence Baljer, Pedro Ciudad, Oscar J. Manrique, Bulent Sacak, Georgios Orfaniotis, Hung Chi Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Background: Free colon flap is the preferred method of hypopharynx reconstruction when the defect is substantial, or simultaneous voice reconstruction is planned. Most of the complications in free colon flaps are located at the anastomosis between colon and thoracic esophagus due to size mismatch of the lumen. We present our experience comparing a modified anastomosis technique and a conventional anastomosis technique at the distal end of interposed colonic segment. Methods: In this retrospective review, 94 patients, divided into two groups, underwent hypopharynx reconstruction. Group A (18 patients), conventional anastomoses between colon and thoracic esophagus was performed, while in Group B (76 patients), underwent the modified method of anastomosis. Results: The average follow-up period was 46 months in group A and 54 months in group B. Fistula formation was found in 2 patients from Group A, and 1 patient from Group B. Strictures were observed in 4 patients from Group A, and 1 patient from Group B. Difference between both groups regarding complications of leakage and stricture formation was statistically significant (p < 0.05). Conclusion: Modified method for anastomosis between colon and thoracic esophagus was found to be effective in the reduction of complications associated with the use of a free colon flap for hypopharyngeal reconstruction. Further advances of this technique could gain momentum in the future.

Original languageEnglish
Pages (from-to)907-912
Number of pages6
JournalAsian Journal of Surgery
Volume43
Issue number9
DOIs
StatePublished - 09 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020

Keywords

  • Deglutition
  • Deglutition disorders
  • Free colon flap
  • Hypopharyngeal cancer
  • Hypopharynx reconstruction
  • Voice reconstruction

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