TY - JOUR
T1 - Donor-site morbidity after free ileocolon flap transfer for esophageal and voice reconstruction
AU - Rampazzo, Antonio
AU - Salgado, Christopher J.
AU - Gharb, Bahar Bassiri
AU - Mardini, Samir
AU - Di Spilimbergo, Stefano Spanio
AU - Chen, Hung Chi
PY - 2008/12
Y1 - 2008/12
N2 - BACKGROUND: Radical excision of advanced hypopharyngeal and laryngeal tumors usually compromises both swallowing and speech. Among the available reconstruction methods, the free ileocolon flap allows rehabilitation of both functions in one stage. The donor-site morbidity of this flap has not been addressed in head and neck cancer patients. METHODS: A retrospective study was conducted in 34 patients between April of 2003 and December of 2007 to investigate donor-site morbidity in patients undergoing reconstruction with free ileocolon flaps. Complications such as diarrhea, upper gastrointestinal tract distress, bowel leak, abscess, or hernia formation were evaluated. Significant association of diarrhea and upper gastrointestinal distress, previous abdominal operations, systemic diseases, primary versus secondary reconstruction, flap length, and postoperative chemotherapy were subsequently evaluated. Differences were considered significant for values of p ≤ 0.05. RESULTS: There were no perioperative or postoperative deaths. Nineteen patients (56 percent) experienced temporary diarrhea. In all but two patients, diarrhea discontinued by 4 months. Chemotherapy was significantly associated with diarrhea (p < 0.01). Colchicine, terbinafine, and heroin withdrawal episodically caused diarrhea but statistical conclusions could not be drawn. Six patients (18 percent) suffered from upper gastrointestinal tract problems (gastroduodenal ulcer, erosive gastritis, and minor bleeding), probably because of insufficient gastric protection. CONCLUSIONS: The free ileocolon flap proved to be a reliable method when simultaneous restoration of swallowing and speech was required, with donor-site morbidity comparable to that of the other intestinal flaps.
AB - BACKGROUND: Radical excision of advanced hypopharyngeal and laryngeal tumors usually compromises both swallowing and speech. Among the available reconstruction methods, the free ileocolon flap allows rehabilitation of both functions in one stage. The donor-site morbidity of this flap has not been addressed in head and neck cancer patients. METHODS: A retrospective study was conducted in 34 patients between April of 2003 and December of 2007 to investigate donor-site morbidity in patients undergoing reconstruction with free ileocolon flaps. Complications such as diarrhea, upper gastrointestinal tract distress, bowel leak, abscess, or hernia formation were evaluated. Significant association of diarrhea and upper gastrointestinal distress, previous abdominal operations, systemic diseases, primary versus secondary reconstruction, flap length, and postoperative chemotherapy were subsequently evaluated. Differences were considered significant for values of p ≤ 0.05. RESULTS: There were no perioperative or postoperative deaths. Nineteen patients (56 percent) experienced temporary diarrhea. In all but two patients, diarrhea discontinued by 4 months. Chemotherapy was significantly associated with diarrhea (p < 0.01). Colchicine, terbinafine, and heroin withdrawal episodically caused diarrhea but statistical conclusions could not be drawn. Six patients (18 percent) suffered from upper gastrointestinal tract problems (gastroduodenal ulcer, erosive gastritis, and minor bleeding), probably because of insufficient gastric protection. CONCLUSIONS: The free ileocolon flap proved to be a reliable method when simultaneous restoration of swallowing and speech was required, with donor-site morbidity comparable to that of the other intestinal flaps.
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U2 - 10.1097/PRS.0b013e31818cc11e
DO - 10.1097/PRS.0b013e31818cc11e
M3 - Article
C2 - 19050489
AN - SCOPUS:58149386983
VL - 122
SP - 186e-194e
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
SN - 0032-1052
IS - 6
ER -