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Reconstructive techniques currently used following resection of hypopharyngeal carcinoma

Published online by Cambridge University Press:  29 June 2007

C. A. Ayshford ,
R. M. Walsh  and
J. C. Watkinson
C. A. Ayshford*
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
R. M. Walsh
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
J. C. Watkinson
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital, Birmingham, UK.
*
Address for correspondence: C. A. Ayshford, Dept of Otolaryngology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TN. Fax: 0121 627 2299
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Abstract

There is no general consensus as to the best method of reconstruction following total laryngopharyngectomy for hypopharyngeal carcinoma. The aim of this study is to attempt to establish the current practice amongst British ENT Consultants and to ascertain the reasons for their choice of reconstructive technique.

An anonymous questionnaire was sent to 546 consultants in the UK and the results of 363 (66.5 per cent) were analysed. One hundred and twenty-eight (35.3 per cent) consultants replied that they performed surgery for hypopharyngeal carcinoma. Sixty-five (50.8 per cent) performed a stomach pull-up procedure, 23 (18 per cent) used a jejunal free flap, 36 (28.1 per cent) used both and four (3.1 per cent) used other techniques. In the stomach pull-up group, the main reasons given for their choice were because there was no lower resection margin (48 out of 65) and because of tradition in the way they were trained (37 out of 65). In the group using the jejunal free flap, lower morbidity (18 out of 23) and mortality (14 out of 23) were the main reasons for their choice. The questionnaire also found that amongst the 60 consultants who would consider using a jejunal free flap, the majority (39) aimed for a lower clearance margin of 2–4 cm, while 17 aimed for >4 cm clearance.

This study provides a good indication of the current practice in the UK of reconstruction following resection for hypopharyngeal carcinoma. It appears that the stomach pull-up remains the most commonly used method of reconstruction, but the jejunal free flap is becoming increasingly more popular because of its lower morbidity and mortality.

Keywords

Hypopharyngeal neoplasmsPharyngectomySurgical flaps
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 2 , February 1999 , pp. 145 - 148
Copyright
Copyright © JLO (1984) Limited 1999

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