Details der Publikation - Fascio-cutaneous-free flaps as primary reconstruction in salvage total laryngectomy

Fascio-cutaneous-free flaps as primary reconstruction in salvage total laryngectomy

Introduction Salvage total laryngectomy (STL) is the most common treatment for recurrent laryngeal cancer after (chemo)-radiotherapy [(C)RT]. In this scenario, a higher rate of local wound complications, such as pharyngo-cutaneous fistula (PCF) and pharyngo-esophageal stenosis (PES), is generally expected. The aim of the present study is to evaluate outcomes using a standardized reconstructive protocol. Methods Between 2009 and 2019, patients undergoing STL after (C)RT were collected at two referral hospitals with the objective of evaluating surgical outcomes using a standardized reconstructive policy based on the use of fascio-cutaneous free flaps as inlay patch grafts and a long-lasting salivary bypass stent. Results Fifty-five patients (mean age, 66 years; male-to-female ratio, 8:1) were included in the study. Previous treatments were RT in 22 (40%) patients, CRT in 21 (38.2%), and partial laryngeal surgery followed by adjuvant (C)RT in 12 (21.8%). Reconstruction was accomplished by radial forearm and anterolateral thigh free flaps in 16 (29.1%) and 39 (70.9%) patients, respectively. Flap success rate was 98.2%. Concerning postoperative complications, we encountered 3 PCFs (5.4%) and 1 PES (1.8%). Conclusion The standardized reconstructive protocol analyzed herein granted significantly lower rates of PCF and PES after STL compared with data available in the literature..

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:278
Enthalten in:	European archives of oto-rhino-laryngology and head & neck - 278(2020), 1 vom: 24. Juni, Seite 219-226

Sprache:	Englisch

Beteiligte Personen:	Piazza, Cesare [VerfasserIn] Paderno, Alberto [VerfasserIn] Del Bon, Francesca [VerfasserIn] Grammatica, Alberto [VerfasserIn] Montalto, Nausica [VerfasserIn] Bresciani, Lorenzo [VerfasserIn] Giannini, Lorenzo [VerfasserIn] Incandela, Fabiola [VerfasserIn] Fontanella, Walter [VerfasserIn] Nicolai, Piero [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

BKL:	44.94$jHals-Nasen-Ohrenheilkunde
Themen:	Anterolateral thigh Complication Free flap Pharyngo-cutaneous fistula Pharyngo-esophageal stenosis Radial forearm Reconstructive surgery Salvage surgery Total laryngectomy

Anmerkungen:	© Springer-Verlag GmbH Germany, part of Springer Nature 2020

doi:	10.1007/s00405-020-06137-x

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2122781742

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520			\|a Introduction Salvage total laryngectomy (STL) is the most common treatment for recurrent laryngeal cancer after (chemo)-radiotherapy [(C)RT]. In this scenario, a higher rate of local wound complications, such as pharyngo-cutaneous fistula (PCF) and pharyngo-esophageal stenosis (PES), is generally expected. The aim of the present study is to evaluate outcomes using a standardized reconstructive protocol. Methods Between 2009 and 2019, patients undergoing STL after (C)RT were collected at two referral hospitals with the objective of evaluating surgical outcomes using a standardized reconstructive policy based on the use of fascio-cutaneous free flaps as inlay patch grafts and a long-lasting salivary bypass stent. Results Fifty-five patients (mean age, 66 years; male-to-female ratio, 8:1) were included in the study. Previous treatments were RT in 22 (40%) patients, CRT in 21 (38.2%), and partial laryngeal surgery followed by adjuvant (C)RT in 12 (21.8%). Reconstruction was accomplished by radial forearm and anterolateral thigh free flaps in 16 (29.1%) and 39 (70.9%) patients, respectively. Flap success rate was 98.2%. Concerning postoperative complications, we encountered 3 PCFs (5.4%) and 1 PES (1.8%). Conclusion The standardized reconstructive protocol analyzed herein granted significantly lower rates of PCF and PES after STL compared with data available in the literature.
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Fascio-cutaneous-free flaps as primary reconstruction in salvage total laryngectomy

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