Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma Fei Chen1†, Jun Liu1,2†, Lihong Wang1, Dan Lv1, Yuanzhi Zhu1, Qi Wu1, Guojun Li2*, Hongliang Zheng3* and Xiaofeng Tao4*
Abstract Objectives: The aim of this article was to determine outcomes in patients with squamous cell carcinoma of the hypopharynx (SCCHP) in whom the free posterior tibial flap was used for primary reconstruction of hypopharynx defects after cancer resection. Subjects and methods: Between August 2009 and February 2012, 10 patients with SCCHP underwent posterior tibial flap reconstruction for hypopharynx defects. The corresponding clinical data were retrospectively collected and analyzed. Results: Despite the multistep and time-consuming procedure, the posterior tibial flap survival rate was 100%. Operation-induced complications did not occur in four patients. Six patients developed postoperative hypoproteinemia, four patients developed postoperative pulmonary infections, and four patients developed pharyngeal fistula. The pharyngeal and laryngeal functions of all patients were preserved. Conclusion: Our experience demonstrates that the posterior tibial flap is a safe and reliable choice for the reconstruction of hypopharynx defects. Keywords: Hypopharyngeal cancer, Posterior tibial flap, Reconstruction
Background Squamous cell carcinoma of the hypopharynx (SCCHP) is a highly aggressive malignant tumor and generally diagnosed at an advanced stage. SCCHP has the particular trait of invasiveness through the submucosa to induce distant lesions, also known as skip lesions [1], and thus total laryngopharyngectomy with adjuvant radiotherapy is widely utilized in late-stage SCCHP [2]. Although the majority of patients with selected pyriform sinus cancer treated with conservation surgery had successful laryngeal function preservation and better survival [3], * Correspondence: [email protected]; [email protected]; [email protected] † Equal contributors 2 Department of Head and Neck Surgery, the University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA 3 Department of Otorhinolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, People’s Republic of China 4 Radiology Department of Shanghai Ninth People’s Hospital Affiliated Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai 200011, People’s Republic of China Full list of author information is available at the end of the article
pharyngolaryngeal reconstruction following SCCHP resection still remains a surgical challenge. Over the years several pharyngolaryngeal reconstruction methods have been developed, such as the myocutaneous flap, gastric pull-up, and jejunal free flap techniques. With the development of microsurgical techniques, several fasciocutaneous free flaps from the radial forearm and anterolateral thigh have been widely utilized for the reconstruction
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