Prefabricated tensor fascia lata myocutaneous flap for total esophageal reconstruction - A case report

For the reconstruction of a long segment or total defect of the esophagus, the stomach and colon are the first choices among the substitutes, and the jejunum follows. In case of limited use of all intraabdominal viscuses, the free fasciocutaneous and myocutaneous flaps provide another choice. The prefabricated tensor fascia lata myocutaneous flap can provide a longer and more secure substitute. One patient who needed reconstruction of the entire esophagus due to corrosive injury in 1996 was presented. The stomach, colon and jejunum were not available because of previous intraabdominal operations. The extended tensor fascia lata nap was elevated anteriorly and posteriorly and rolled into a tubular form with skin inside in the first stage. In the second stage, the microsurgical transfer of the prefabricated flap to reconstruct the esophagus in the neck via the subcutaneous tunnel was performed. In the third stage, the lower end of the flap was joined to the jejunum in Roux-en-Y fashion. The patient started oral diet one month after reconstruction. The follow-up esophagogram revealed a good patency. Although the prefabricated tensor fascia lata flap would not be a procedure of first choice, it is a worthwhile backup operation in esophageal reconstruction.