Linked Life Data

16437981

Source:http://linkedlifedata.com/resource/pubmed/id/16437981

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2006-1-27
pubmed:abstractText
Hypopharynx reconstruction must deal with restoration of not a simple tubed conduit but a complex arrangement of constrictive and propulsive forces with fine sensory circuits. The chosen surgical approach should guarantee both complete removal of tumor and re-establishement of the two primary functions of the district: first swallowing and then phonation. We retrospectively reviewed data of 67 patients who had undergone oncologic reconstruction of hypopharynx with either pedicled or free flaps at the ENT Department of IRCCS Policlinico S Matteo, University of Pavia, between November 1994 and July 2004. Type and extension of the defect following cancer removal guided the selection of reconstructive procedure. Partial defects, with more than 50% mucosa spared, in absence of chance of being closed primarly, were covered with radial forearm free flaps as first choice; pedicled flaps such as pectoralis major and SCM rotational flaps were used instead if free flaps contraindicated by general and/or local conditions. With circumferential defects reconstruction was accomplished by means of jejunum free flap, as first choice. Adverse local abdominal conditions mandated the alternative use of either tubulized or tunnelized fasciocutaneous free flaps, such as radial forearm and lateral thigh. When free flaps use contraindicated, or in case of salvage surgery after flap loss, pectoralis major and latissimus dorsi pedicled flap were chosen. Both reconstructions with free and pedicled flaps were successful in an high percentage of cases (>85%). Analysis of incidence and causes of flap failure are reported in this work. In the free flaps group of patients a lower rate of complications were registered, allowing a faster patient discharge from hospital (36% versus 81.3%). An oral swallowing function was gained in 92% of free flaps and 62.5% of pedicled flaps. Excellent and exclusive oral nutrition (free diet), was obtained in 54% of free flaps and 25% of pedicled flaps. None of patients undergone laryngectomy coupled in both groups with pharyngectomy achieved an intelligible esophageal speech. Only patients in the free flaps group benefitted from voice prosthesis implant: in fact this procedure was avoided in pedicled flaps due to the excessive tissue bulk. In conclusion, the data collected suggest that free flaps rapresent the first choice for both partial and total oncologic hypopharyngeal reconstruction, while pedicled flaps should be taken into account when free ones contraindicated by general or vascular conditions.
pubmed:language
ita
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:author
pubmed:volume
4
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
S190-2
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:articleTitle
[Decisional algorithm in extended neoplasms of the hypopharynx and the cervical esophagus].
pubmed:affiliation
Clinica Otorinolaringoiatrica, IRCCS Policlinico S Matteo, Università degli Studi, Pavia.
pubmed:publicationType
Journal Article, English Abstract