DISCLAIMERS

contact us >>

Free flap reconstruction of the hypopharynx: A retrospective analysis of patients and outcomes at the University of Pittsburgh from 2002 to 2012.

Isaac James, Ivan Vial, T. Oguz Acarturk
University of Pittsburgh School of Medicine (Medical Student)
2014-03-01

Presenter: Isaac James

Affidavit:
100% original

Director Name:

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

BACKGROUND: Reconstruction of hypopharyngeal defects after tumor ablation is associated with a high rate of post-operative complications. Identification of risk factors is crucial for proper patient selection and operative planning.
METHODS: Patients who underwent free flap reconstruction of hypopharyngeal defects after tumor ablation at the University of Pittsburgh Medical Center were identified via CPT code. Data was collected retrospectively with regard to demographics, co-morbidities, radiation history, flap type, surgical defect, and post-operative complications.
RESULTS: 56 patients (44 male and 12 female, median age 60) met inclusion criteria for the study. Mean length of follow up was 509 days post-operative. 23 (41%) received a radial forearm flap (RFF), 17 (30%) received a jejunal flap (JF), and 16 (29%) received an anterolateral thigh flap (ALT). When compared to ALT, patients receiving JF experienced longer average post-operative hospital stay (30 days vs. 12 days, p=0.01) and increased flap loss (24% vs. 0%, p=0.018). Readmissions, minor post-operative complications, and complications requiring return to the OR were not significantly different between flap types. 13% of ALT flaps, 26% of RF, and 29% of JF developed fistulas at a median of 25 days post-op, but these comparisons did not reach statistical significance.
CONCLUSION: Complication rates in hypopharyngeal reconstruction remain significant. ALT flaps may provide some advantage when compared to JF with shorter hospital stay and reduced risk of flap loss. Although outcomes may vary by region or by surgeon, the trends borne out in our data merit further investigation with an expanded sample.

Ohio,Pennsylvania,West Virginia,Indiana,Kentucky,Pennsylvania American Society of Plastic Surgeons

OVSPS Conference