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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
Â
=
Â
33
)
,
PMMF
for
group
(
2
)
(
n
Â
=
Â
34
)
,
and
JFF
for
group
(
3
)
(
n
Â
=
Â
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
Â
%
with
a
perioperative
mortality
rate
of
6
.
7
Â
%
and
there
was
no
significant
difference
between
the
three
groups
.
There
was
no
graft
necrosis
in
group
(
1
)
compared
to
5
.
9
Â
%
in
group
(
2
)
and
5
.
4
Â
%
in
group
(
3
)
.
Pulmonary
complications
occurred
commonly
(
30
.
3
Â
%
)
in
group
(
1
)
compared
to
11
.
8
Â
%
in
group
(
2
)
and
10
.
8
Â
%
in
group
(
3
)
The
overall
3
Â
years
survival
rate
was
67
.
3
Â
%
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
"esophageal carcinoma"
symptom
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
This symptom has already been validated
