Functional outcome following free ileocolic flap in total pharyngolaryngectomy.

摘要

CONCLUSION: Reconstruction after radical resection for advanced laryngeal and hypopharyngeal cancer can be carried out with low mortality, acceptable morbidity, and a promising functional outcome. OBJECTIVES: To evaluate the functional outcome of reconstruction by a free vascularized ileocolic flap after concurrent chemoradiotherapy (CCRT) and surgery for advanced laryngeal and hypopharyngeal cancer. PATIENTS AND METHODS: Fifteen patients (all male, mean age 49.8 years) with squamous cell carcinoma of larynx (n=1) or hypopharynx (n=14) received a circumferential pharyngolaryngectomy and resection of the proximal esophagus followed by postoperative CCRT (60-65 Gy, cisplatin and 5-fluorouracil). A single-stage reconstruction was performed with a free vascularized ileocolic flap using a microsurgical technique. RESULTS: The course of all operations was uneventful. Eight patients were alive at a follow-up of 24 months after operation, while seven patients died from local recurrence, distant metastasis, andsuicide. Relief of dysphagia was achieved in 14 cases. Speech intelligibility was recorded in five patients.