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Hypopharyngeal reconstruction: a comparison of three alternatives.
[esophageal carcinoma]
This
study
aimed
to
evaluate
the
operative
outcomes
of
using
gastric
pull-up
(
GPU
)
,
pectoralis
major
myocutaneous
flap
(
PMMF
)
,
and
jejunal
free
flap
(
JFF
)
to
reconstruct
the
hypopharynx
after
resection
of
hypopharyngeal
and
cervical
esophageal
carcinoma
.
Retrospective
clinical
study
.
Otolaryngology
Department
,
Zagazig
University
Hospital
,
Egypt
and
Surgical
Department
,
National
Cancer
Institute
,
Cairo
,
Egypt
.
Records
of
104
patients
who
underwent
resection
of
carcinoma
of
the
hypopharynx
and
cervical
esophagus
were
reviewed
to
determine
the
indications
for
radical
resection
,
location
,
and
stage
of
the
primary
tumor
,
gross
and
pathological
surgical
resection
margins
,
operative
complications
,
morbidity
,
and
mortality
.
Reconstruction
was
performed
using
the
GPU
for
group
(
1
)
(
n
=
33
)
,
PMMF
for
group
(
2
)
(
n
=
34
)
,
and
JFF
for
group
(
3
)
(
n
=
37
)
.
The
hypopharynx
was
the
most
common
primary
tumor
site
for
group
(
2
)
and
group
(
3
)
whereas
group
(
1
)
had
lesions
more
frequently
in
the
cervical
esophagus
.
The
overall
postoperative
morbidity
rate
was
20
.
2
%
with
a
perioperative
mortality
rate
of
6
.
7
%
and
there
was
no
significant
difference
between
the
three
groups
.
There
was
no
graft
necrosis
in
group
(
1
)
compared
to
5
.
9
%
in
group
(
2
)
and
5
.
4
%
in
group
(
3
)
.
Pulmonary
complications
occurred
commonly
(
30
.
3
%
)
in
group
(
1
)
compared
to
11
.
8
%
in
group
(
2
)
and
10
.
8
%
in
group
(
3
)
The
overall
3
years
survival
rate
was
67
.
3
%
and
there
was
no
significant
difference
between
the
three
groups
.
The
outcomes
of
the
three
techniques
are
equally
successful
when
used
appropriately
.
The
nature
of
the
defect
indicates
the
method
of
reconstruction
.
For
short
reconstruction
above
the
thoracic
inlet
,
PMMF
or
JFF
are
equally
effective
and
in
tumors
requiring
total
esophagectomy
,
GPA
is
indicated
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
