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Pectoralis Major Myocutaneous Flap for Reconstruction of Circumferential Pharyngeal Defects
Mark S. Burke MD; Seth E. Kaplan BS; Maria M. Lotempio MD; Wesley L. Hicks, Jr. MD; Thom R. Loree MD
Roswell Park Cancer Institute [Buffalo, NY] and SUMMA Health System [Akron, OH]
2010-03-31
Presenter: Mark Burke, MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background. A 270-degree partially tubed pectoralis major myocutaneous (PMMF) flap is an excellent option for total circumferential pharyngoesophageal defects in patients who are not candidates for more complex reconstructions.
Methods. Patients undergoing circumferential pharyngoesophageal reconstruction with PMMF were reviewed. End points were stricture, fistula, resumption of oral intake, perioperative death, and recurrence.
Results. Eleven patients underwent 270 degree PMMF for reconstruction. Six (55%) were male and five (45%) were female. Ages 42 to 78 years (mean 62 years). Three patients (27%) developed fistulas and two (18%) developed stenosis. Ten patients (91%) were able to resume adequate nutrition via oral intake. There were no perioperative deaths.
Conclusions. Patients with severe comorbidities, metastatic disease, a lack of donor vessels, or a potentially hostile abdomen may not be ideal candidates for visceral rearrangement procedures. For these patients, partially-tubed PMMF utilizing the prevertebral fascia provides a reliable alternative for reconstruction with excellent functional results.
