Postoperative Complications and Swallowing Function after Jejunal and Skin Flap Reconstruction for Hypopharyngeal Carcinoma-A Multicenter Retrospective Study.

Kunihiko Tokashiki,Kouki Miura,Takahito Kondo,Isaku Okamoto,Takashi Matsuki,Hiroki Sato,Taku Yamashita,Go Omura,Kiyoaki Tsukahara,Tatsuo Masubuchi,Chihiro Fushimi,Takuro Okada

doi:10.3390/jcm11051464

Abstract

This study compared the incidence of perioperative complications and swallowing function between free jejunal flap reconstruction and cutaneous free tissue flap construction. We included 223 patients who underwent hypopharyngeal reconstruction using free flap. At discharge, +the free jejunal flap was associated with a Functional Oral Intake Scale (FOIS) score of 1–6 in 132 cases (70%) and a score of 7 in 56 cases (30%). Regarding the cutaneous free tissue flaps, FOIS scores of 1–6 were observed in 18 cases (51%), and a score of 7 was noted in 17 cases (49%). Donor site complications occurred in 12% of the patients who underwent free jejunal flap procedures and in none of the patients who underwent cutaneous free tissue flap procedures. We found that the free jejunal flap had a regular dietary intake rate in 56 patients (30%), whereas cutaneous free tissue flaps had a regular dietary intake rate in 17 patients (49%). Cutaneous free tissue flaps had a significantly higher regular dietary intake rate at discharge and a significantly lower incidence of donor site complications than free jejunal flaps. In conclusion, free-flap reconstruction may be a better method than free jejunal flap reconstruction for the treatment of hypopharyngeal cancer.

Highlights

Head and neck cancer remains a significant public health burden, causing significant mortality and morbidity [1]
Reconstruction in the 223 patients with hypopharyngeal cancer consisted of free jejunal flap reconstruction (n = 188) and cutaneous free tissue flap reconstruction (n = 35)
The pyriform sinus consisted of 133 free jejunal flaps and cutaneous free tissue flaps, whereas the postcricoid region consisted of free jejunal flaps and eight cutaneous free tissue flaps

Summary

Introduction

Head and neck cancer remains a significant public health burden, causing significant mortality and morbidity [1]. The worldwide incidence of hypopharyngeal cancer has increased, with tobacco and alcohol consumption being its major risk factors [2]. In. Japan, free jejunal flap reconstruction is recommended for the treatment of hypopharyngeal cancer [3]. A free jejunal flap requires laparotomy, and intestinal obstruction is a problematic complication of laparotomy [4]. Cutaneous free tissue flaps have been used as reconstruction material [5]. Findings regarding the benefits of cutaneous free tissue flaps compared to free jejunal flaps are scattered across the literature [6,7]

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Results

Discussion

Conclusion