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Abstract
Background: We devised an advanced pectoral flap (APF) to prevent anastomotic leak after total pharyngolaryngectomy (TPL) and free jejunal reconstruction (FJR) in patients with hypopharyngeal or laryngeal carcinoma. The APF alleviates tension on the skin in the neck, reduces the subcutaneous dead space, and promotes adhesion between the neck skin and the anastomosis.
Objective: To investigate whether an APF is effective for prevention of anastomotic leak associated with TPL/FJR.
Patients and methods: Anastomotic leak was compared between APF (n = 65) and non-APF groups (n = 25). Patients who had received preoperative radiotherapy or undergone tracheostomy or skin infiltration requiring neck reconstruction using a pedicle flap were excluded.
Results: There were significantly fewer cases of anastomotic leak in the APF group than in the non-APF group (1.5% [1/65] vs. 16.0% [4/25]; p = .02). An APF could be created bilaterally within approximately 15 minutes. Unlike a deltopectoral flap, an APF does not require a skin graft.
Conclusions: The postoperative anastomotic leak rate was 1.5% in patients who underwent TPL and FJR for hypopharyngeal or laryngeal carcinoma with an APF.
Significance: An APF is easily created and can reduce the incidence of anastomotic leak after TPL and FJR.
Chinese abstract
背景：我们设计了一种先进的胸皮瓣（APF）, 以防止下咽喉癌或喉癌患者全咽咽喉切除术（TPL）和游离空肠重建（FJR）后的接合口漏。 APF能缓解颈部皮肤的紧张, 减少皮下死腔, 促进颈部皮肤与接合之间的粘连。
目的：探讨APF是否能有效预防与TPL/FJR相关的接合口漏。
患者和方法：比较APF（n = 65）和非APF组（n = 25）之间的接合口漏。接受术前放疗或接受气管切开术或皮肤浸润而需要使用椎弓根皮瓣进行颈部重建的患者被排除在外。
结果：APF组接合口漏的病例明显少于非APF组（1.5％[1/65]对16.0％[4/25]; p = 0.02）。APT可以在大约15分钟内从两侧做成。与胸三角皮瓣不同, APF不需要皮肤移植。
结论：在接受TPL和FJR治疗下咽癌或喉癌时使用APF的患者术后接合口漏率为1.5％。
意义：APF易于制造, 可以减少TPL和FJR术后接合口漏的发生率。
Disclosure statement
No potential conflict of interest was reported by the authors.