Pectoralis Major Myocutaneous Flap in Reconstruction after Salvage Laryngectomy | ||
| Sohag Medical Journal | ||
| Volume 28, Issue 3, 2024, Pages 160-167 PDF (1.04 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/smj.2024.319541.1494 | ||
| Authors | ||
| mahmoud Mohammed Abdelghany* 1; Ayman Amine2; Francesco Bussu3; Tarek El-sayed Fetohy4; Islam Amer5; Asem Elsani Hassan6 | ||
| 1maxillofacial surgery unit, department of general, oncological and laparoscopic surgery, faculty of medecine, sohag university | ||
| 2Surgery Department, National Cancer Institute (NCI), Cairo University, Kasr El-Aini Street, Fom El-Khalig, Cairo, 11796, Egypt. | ||
| 3Otolaryngology Division, Azienda Ospedaliero Universitaria, Viale San Pietro 12, 07100 Sassari, Italy | ||
| 4General Surgery and Maxillofacial Surgery, Sohag University | ||
| 5Maxillofacial Surgery Unit, Department of General Surgery, Oncological and Laparoscopic Surgery, Faculty of Medicine, Sohag University, Sohag University Street, Sohag City,Egypt | ||
| 6Department of General Surgery, Oncological and Laparoscopic Surgery, Faculty of Medicine, Sohag University, Sohag University Street, Sohag City, Egypt | ||
| Abstract | ||
| Background: Pharyngocutaneous fistula (PCF) is a major complication post salvage total laryngectomy (STL), mostly secondary to the effect of radiotherapy (RT) on tissue healing. It usually leads to other complications such as bleeding, wound infection, and wound dehiscence. Aims/Objective: This study aims to evaluate the outcomes of PMMF reconstruction post-STL in patients with recurrent tumours following primary treatment by CRT with a detailed analysis of all complications and causes of death. Materials and methods: A retrospective study involved 29 patients operated in the National Cancer Institute, Cairo, Egypt in the period between January 2015 and December 2021 by STL and reconstruction by PMMF for recurrent tumours post primary treatment by radio(chemo)therapy. Results: Our study included 29 patients; mean age was 54.8±10.24 years. All patients were males. All patients were operated by STL and reconstructed by PMMF, 16 (55.2%) patients complicated by pharyngocutaneous fistulae, mortality rate was high (62.1%). Conclusion: Recommendations for routine use of PMMF in salvage settings should be reevaluated and reconsidered. Regarding lowering the incidence of PCF, the PMMF has no objectively beneficial effect. However, it promotes faster healing of minor fistulas, and prevents larger fistula formation. Appropriate postoperative care and improvement of the nutritional state of the patient may reduce the incidence of PCF. | ||
| Keywords | ||
| Salvage Laryngectomy; Pectoralis Major Muscle Flap; Pharyngocutaneous Fistula; Laryngeal cancer | ||
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