Bowel preparation before microvascular free colon transfer for head and neck reconstruction

Is it necessary?

Samir Mardini, Hung Chi Chen, Christopher Salgado, Chia Ming Hsu, Kuang Te Chen, Guan Ming Feng

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Mechanical bowel preparation before any intestinal operation, especially when the large intestine is involved, is routine practice for most surgeons. This practice has been questioned by many colorectal surgeons, with convincing data showing the lack of benefit of preoperative mechanical bowel preparation. Free microvascular transfer of the large intestine is occasionally performed for reconstruction of the upper esophagus, as it provides a better size match for the oropharynx than other visceral organs. Nine patients underwent reconstruction of the cervical esophagus and voice tube using a segment of ileocolon. In all patients, the cervical esophagus was reconstructed using the ascending colon and the voice tube was reconstructed using the ileal segment. Both were transferred as one free flap. All patients underwent the procedure without any form of preoperative mechanical bowel preparation. The patients were able to tolerate a solid diet at the end of the mean follow-up period of 7 months, and all esophagograms showed no evidence of stricture formation. One patient developed a fistula at the recipient site that was treated with a regional flap, one patient developed a superficial wound infection of the abdominal wall, and one patient developed a postoperative abdominal wound dehiscence after several episodes of excessive coughing. Microvascular transfer of a large intestinal segment without preoperative mechanical bowel preparation for the reconstruction of the esophagus is a safe procedure. It can avoid the discomfort and complications associated with mechanical bowel preparation. If preoperative mechanical bowel preparation is preferred, the results of this study, which are based on nine patients, demonstrate the safety of this practice in cases where the patient did not follow proper instructions or in cases where the use of the colon was not anticipated preoperatively.

Original languageEnglish
Pages (from-to)1916-1922
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume113
Issue number7
DOIs
StatePublished - Jun 1 2004
Externally publishedYes

Fingerprint

Colon
Neck
Head
Esophagus
Large Intestine
Ascending Colon
Oropharynx
Free Tissue Flaps
Abdominal Wall
Wound Infection
Patient Safety
Fistula
Pathologic Constriction
Diet
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Bowel preparation before microvascular free colon transfer for head and neck reconstruction : Is it necessary? / Mardini, Samir; Chen, Hung Chi; Salgado, Christopher; Hsu, Chia Ming; Chen, Kuang Te; Feng, Guan Ming.

In: Plastic and Reconstructive Surgery, Vol. 113, No. 7, 01.06.2004, p. 1916-1922.

Research output: Contribution to journalArticle

Mardini, Samir ; Chen, Hung Chi ; Salgado, Christopher ; Hsu, Chia Ming ; Chen, Kuang Te ; Feng, Guan Ming. / Bowel preparation before microvascular free colon transfer for head and neck reconstruction : Is it necessary?. In: Plastic and Reconstructive Surgery. 2004 ; Vol. 113, No. 7. pp. 1916-1922.
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