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Multicenter Study
. 2024 Jun;46(6):1351-1361.
doi: 10.1002/hed.27667. Epub 2024 Jan 31.

Fasciocutaneous and jejunal free flaps for circumferential hypopharyngeal defect reconstruction: A 22-year multicenter cohort study

Anthony M Tonsbeek  1 , Caroline A Hundepool  1 , Merel M Smit  2 , Pieter S Verduijn  2 , Liron S Duraku  3 , Aniel Sewnaik  4 , Bas P L Wijnhoven  5 , Marc A M Mureau  1
Affiliations
Multicenter Study

Fasciocutaneous and jejunal free flaps for circumferential hypopharyngeal defect reconstruction: A 22-year multicenter cohort study

Anthony M Tonsbeek et al. Head Neck. 2024 Jun.

Abstract

Background: It remains unclear whether a tubed fasciocutaneous or jejunal free flap (FCFF and JFF) is preferable for reconstruction of circumferential pharyngolaryngoesophageal defects.

Methods: All consecutive patients with circumferential pharyngolaryngoesophageal defects reconstructed with an FCFF or JFF between 2000 and 2022 were included. Outcomes of interest were rates of fistulas, strictures, and donor-site complications.

Results: In total, 112 patients were included (35 FCFFs and 77 JFFs). Fistula and stricture rates were significantly lower following JFF compared to FCFF reconstructions, with 12% versus 34% (p = 0.008) and 29% versus 49% (p = 0.04), respectively. Severe donor-site complications leading to surgical intervention or ICU admittance only occurred after JFF reconstructions (18%, p = 0.007).

Conclusions: The high fistula and stricture rates in FCFF reconstructions and the rate of severe abdominal complications in JFF reconstructions illustrate inherent procedure-specific advantages and disadvantages. Relative pros and cons should be carefully weighed when tailoring treatments to the individual needs of patients.

Keywords: anterolateral thigh free flap; head and neck cancer; jejunal free flap; postoperative complications; radial forearm free flap; reconstructive microsurgery.

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References

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