Postoperative Complications of Jejunal and Skin Valve Reconstruction in Free Reconstructive Surgery for Hypopharyngeal Carcinoma

Abstract

Background/Aim: This study evaluated the incidence of perioperative complications in jejunal flap compared with the free tissue flap approach. Patients and Methods: This study included 75 patients who underwent free flap reconstruction for hypopharyngeal carcinoma. The primary outcome was the incidence of pharyngocutaneous fistula, and the secondary outcomes were perioperative complications. Results: Pharyngocutaneous fistula developed in 7% of patients who underwent jejunal flap procedures and 6% of patients who underwent free tissue flap procedure. Flap sampling site complications occurred in 23% of patients who underwent jejunal flap procedures and in none of the patients who underwent free tissue flap procedure. Conclusion: No significant difference was observed in the incidence of pharyngocutaneous fistula between the two groups (p=0.99), but complications at the flap sampling site were significantly more common in jejunal flap procedures than in free tissue flap procedures (p=0.03). Free tissue flap procedures are potential reconstruction methods superior to jejunal flap methods. Patients and MethodsPatients. This study enrolled 75 patients who underwent free reconstructive surgery for hypopharyngeal cancer at Tokyo Medical University Hospital from January 1, 2010 to April 30, 2020.Ethics. This study was approved by the ethics committee of the Tokyo Medical University (approval no. T2020-0094). Patients who refused to participate in the study were excluded. All surgeries were 4033

Postoperative Complications and Swallowing Function after Jejunal and Skin Flap Reconstruction for Hypopharyngeal Carcinoma—A Multicenter Retrospective Study

“…Furthermore, some studies have demonstrated the postoperative function of cutaneous free tissue flap [ 8 ]. Our previous study on free jejunal and cutaneous free tissue flaps reconstruction in 75 patients with hypopharyngeal cancer showed no significant difference in the incidence of cervical complications between free jejunal and cutaneous free tissue flaps reconstruction ( p = 0.99); however, we demonstrated significantly higher donor site complications in the free jejunal flap group than in the cutaneous free tissue flap group ( p = 0.03) [ 9 ]. Notably, however, few Japanese studies have demonstrated the benefits of cutaneous free tissue flaps.…”

“…Cervical complications were classified as fistulas, flap necrosis, lymph fistulas, hemorrhage, and infection. We used the surgical procedure described in detail by Tokaashiki et al [ 9 ]. Skin incision and insetting the flap were performed by head and neck surgeons, whereas free jejunal flap reconstruction was performed by a gastroenterologist.…”