Zhang Y, Liu Y, Sun Y, Xu M, Wang XL. Local random flaps for cervical circumferential defect or tracheoesophageal fistula reconstruction after failed gastric pull-up: Two case reports. World J Clin Cases 2021; 9(33): 10328-10336 [PMID: 34904107 DOI: 10.12998/wjcc.v9.i33.10328]
Corresponding Author of This Article
Xiao-Lei Wang, MD, Attending Doctor, Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. wangxlchcams@163.com
Research Domain of This Article
Otorhinolaryngology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 26, 2021; 9(33): 10328-10336 Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10328
Local random flaps for cervical circumferential defect or tracheoesophageal fistula reconstruction after failed gastric pull-up: Two case reports
Ye Zhang, Yang Liu, Yu Sun, Meng Xu, Xiao-Lei Wang
Ye Zhang, Yang Liu, Yu Sun, Meng Xu, Xiao-Lei Wang, Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Wang XL designed the report; Zhang Y and Liu Y collected the clinical data; Zhang Y reviewed the literature and wrote the manuscript; Wang XL, Sun Y, and Xu M edited and revised the manuscript; All authors read and approved the final manuscript.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Lei Wang, MD, Attending Doctor, Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. wangxlchcams@163.com
Received: July 10, 2021 Peer-review started: July 10, 2021 First decision: July 26, 2021 Revised: August 8, 2021 Accepted: September 10, 2021 Article in press: September 10, 2021 Published online: November 26, 2021
Abstract
BACKGROUND
Total pharyngo-laryngo-esophagectomy with a reconstruction of gastric pull-up is the most common treatment method for patients with multiple primary upper digestive tract carcinomas, such as hypopharyngeal carcinoma with thoracic esophageal carcinoma. However, neck circumferential defect and tracheoesophageal fistula after gastric necrosis are still challenging problems for surgeons and patients.
CASE SUMMARY
This case report presents 2 patients who underwent reconstructive surgeries using 4 local random flaps with a split thickness skin graft in the first case, and 6 local random flaps in the second case to close the circumferential defect and tracheoesophageal fistula after failed gastric pull-up. Both patients achieved good swallowing function and could take solid diet without dysphagia postoperatively.
CONCLUSION
For selected patients, local random flaps (with a split thickness skin graft) can be a simple and reliable solution for reconstructing tracheoesophageal fistula or cervical circumferential defect after gastric necrosis, especially when the necrosis extends below the thoracic inlet.
Core Tip: In this paper, we report 2 patients who suffered from cervical circumferential defect and tracheoesophageal fistula, reconstructed with local random flaps (with a split thickness skin graft in the first case), after failed gastric pull-up. Both patients achieved good swallowing function without dysphagia postoperatively. Local random flaps and split thickness skin graft have the advantages of easy to harvest with abundant and flexible donor sites. Herein, local random flaps (with a split thickness skin graft) can be a simple and reliable solution for reconstructing tracheoesophageal fistula or cervical circumferential defect after gastric necrosis.
