Publication: Modified distal anastomosis between colon and thoracic esophagus for hypopharynx reconstruction using free colon flap: A comparison study
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2020-09-01
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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.
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Tıp, Sağlık Bilimleri, Cerrahi Tıp Bilimleri, Medicine, Health Sciences, Surgery Medicine Sciences, CERRAHİ, Klinik Tıp, Klinik Tıp (MED), SURGERY, CLINICAL MEDICINE, Clinical Medicine (MED), Cerrahi, Surgery, Hypopharynx reconstruction, Free colon flap, Voice reconstruction, Hypopharyngeal cancer, Deglutition, Deglutition disorders, FREE JEJUNAL TRANSFER, FASCIOCUTANEOUS FREE FLAPS, CERVICAL ESOPHAGUS, SUBCUTANEOUS PLACEMENT, DIVERSIONARY CONDUIT, VOICE RECONSTRUCTION, ORAL-CAVITY, INTERPOSITION, RESECTION, EXPERIENCE, Hypopharynx reconstruction, Free colon flap, Voice reconstruction, Hypopharyngeal cancer, Deglutition, Deglutition disorders
Citation
Chilgar R. M., Nicoli F., Baljer B., Ciudad P., Manrique O. J., Sacak B., Orfaniotis G., Chen H., "Modified distal anastomosis between colon and thoracic esophagus for hypopharynx reconstruction using free colon flap: A comparison study", ASIAN JOURNAL OF SURGERY, cilt.43, sa.9, ss.907-912, 2020