Pectoralis myocutaneous flap with T-tube drainage for cervical anastomotic leakage after salvage operation

Hirao, Motohiro; Yoshitatsu, Sumiko; Tsujinaka, Toshimasa; Nishiyama, Ayaka; Fujitani, Kazumasa; Nakamori, Shoji; Sawamura, Toshiro; Mishima, Hideyuki; Ikenaga, Masakazu; Masuda, Norikazu; Kitajima, Masaki

doi:10.1007/s10388-005-0067-z

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…However, a literature review generated only a few reports on the use of pedicled flaps for refractory cervical fistula after esophagectomy. 19 , 20 , 21 , 22 , 23 , 24 The patient involved, types of flaps used, and treatment outcome are summarized in Table 2 . Although almost all patients involved in the studies had a satisfactory treatment outcome with regard to anastomotic fistula or stricture, there are only 20 cases reported across these 6 studies.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, only a few studies have demonstrated that vascularized pedicled tissue flaps, such as sternocleidomastoid flaps and pectoralis major myocutaneous flaps (PMF) could be used safely and effectively to cure anastomotic complications. 19 , 20 , 21 , 22 , 23 , 24 However, the role of PMF in management of patients with RCAF is still unknown due to limited case series. In this retrospective study, the efficacy and surgical details in the management of 6 patients with RCAF after esophagectomy for their esophageal cancer using PMF is discussed, and a literature review was performed.…”

Section: Introductionmentioning

confidence: 99%

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Management of refractory cervical anastomotic fistula after esophagectomy using the pectoralis major myocutaneous flap

Deng

et al. 2022

Brazilian Journal of Otorhinolaryngology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of refractory cervical anastomotic fistula after esophagectomy using the pectoralis major myocutaneous flap

Deng

et al. 2022

Brazilian Journal of Otorhinolaryngology

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“…But in some reports there was a high rate of flap necrosis due to poor blood supply. So the pectoralis major muscle flap is the preferred method to repair the esophageal anastomotic leakage after gastric pull-up [ 10 , 11 ]. However, the PMM flap is less flexible and requires a longer and difficult surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Gastrotracheal Fistula as a Result of Transhiatal Esophagectomy for Esophageal Cancer: An Unusual Complication

Salahi

Tahamtan

Ziaian

et al. 2015

Case Reports in Surgery

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Gastrotracheal fistula following open transhiatal esophagectomy (Orringer's technique) for esophageal cancer is an unusual but lethal complication. Surgical intervention with resection of the fistula tract and primary interrupted suturing of gastric and tracheal orifices using a muscle flap interposition has proved to be a successful method. We report the case of a 73-year-old male with an adenocarcinoma of the distal part of the esophagus, who underwent open transhiatal esophagectomy (Orringer's technique) with gastric tube reconstruction and cervical anastomosis. The patient did not receive induction chemoradiotherapy before the esophagectomy. Two attempts of surgical repair of fistula failed and the patient died. Being aware of warning signs such as dyspnea and respiratory distress accompanied by bilious content in the tracheal tube is helpful in the early detection and treatment of this type of fistula.

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“…Therefore, vascularized pedicle tissue flaps are used to repair perforations or fistulas around the cervical anastomosis. In previous reports, the pectoralis major muscle flap has been used comparatively more often for repair [7,22,23,24]. The pectoralis major muscle flap is a good method with which to prevent recurrent fistula formation because of its abundant muscle volume.…”

Section: Discussionmentioning

confidence: 99%

“…Leakage is curable by tissue recovery and granulation in most cases, and intractable esophagocutaneous fistula rarely develops. Intractable fistulas require more aggressive treatment, such as covered stents [19,20], primary closure and vascularized pedicle tissue flaps [7,21,22]. Covered stent insertion into the cervical esophagus often causes strong pharyngeal discomfort or stent migration.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Sternocleidomastoid Flap Repair for Cervical Anastomotic Leakage after Esophageal Reconstruction

Nakajima

Satomura²,

Takahashi³

et al. 2014

Dig Surg

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Background/Aims: The purpose of this study was to investigate the effectiveness of sternocleidomastoid (SCM) flap repair for anastomotic leakage after esophagectomy. Methods: A refractory cutaneous fistula from the gastric stump developed in 8 patients with esophageal cancer who underwent esophagogastric anastomosis after esophagectomy. All patients underwent SCM flap repair. The cutaneous fistula was removed and resutured. The sternal head of the left SCM was dissected from the manubrium of the sternum and sutured onto the repaired gastric stump. Results: The operative duration was 80-220 min (median, 120 min). The amount of intraoperative bleeding ranged from 5 to 182 g (median, 15 g). The absence of recurrent anastomotic leakage was confirmed after the SCM flap repair in every patient. Oral intake was initiated 7-15 days (median, 10 days) after the repair operation without discomfort. Conclusions: SCM flap repair is an effective and minimally invasive treatment method for cervical anastomotic leakage after esophageal reconstruction. This method may be considered in patients with refractory leakage of the gastric stump after staple anastomosis. i 2014 S. Karger AG, Basel

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Pectoralis myocutaneous flap with T-tube drainage for cervical anastomotic leakage after salvage operation

Cited by 8 publications

References 10 publications

Management of refractory cervical anastomotic fistula after esophagectomy using the pectoralis major myocutaneous flap

Management of refractory cervical anastomotic fistula after esophagectomy using the pectoralis major myocutaneous flap

Gastrotracheal Fistula as a Result of Transhiatal Esophagectomy for Esophageal Cancer: An Unusual Complication

Effectiveness of Sternocleidomastoid Flap Repair for Cervical Anastomotic Leakage after Esophageal Reconstruction

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