Impact of internal mammary artery perforator propeller flap in neck resurfacing and fistula closure after salvage larynx cancer surgery: Our experience

Autor: Gaetano Paludetti, Marzia Salgarello, Aurora Almadori, Giuseppe Visconti, Giovanni Di Cintio, Dario Antonio Mele, Stefano Settimi, Eugenio De Corso, Giovanni Almadori
Rok vydání: 2019
Předmět:
Male
Larynx
internal mammary artery perforator flap
medicine.medical_specialty
reconstruction
salvage surgery
medicine.medical_treatment
Laryngectomy
head and neck squamous cell carcinoma
Disease-Free Survival
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Pharyngectomy
Humans
Medicine
Mammary Arteries
030223 otorhinolaryngology
Laryngeal Neoplasms
total laryngectomy
Aged
Retrospective Studies
Aged
80 and over
Salvage Therapy
business.industry
Chemoradiotherapy
Fistula closure
Middle Aged
Plastic Surgery Procedures
medicine.disease
Head and neck squamous-cell carcinoma
Surgery
Survival Rate
medicine.anatomical_structure
Otorhinolaryngology
030220 oncology & carcinogenesis
Mammary artery
Female
Salvage surgery
Settore MED/31 - OTORINOLARINGOIATRIA
business
Perforator Flap
Cancer surgery
Zdroj: Head & Neck. 41:3788-3797
ISSN: 1097-0347
1043-3074
Popis: BACKGROUND Salvage total laryngectomy (TL) and laryngopharyngectomy (LP) after chemoradiotherapy may produce disfiguring defects with severe complications that require complex reconstructions. METHODS Between January 2012 and December 2018, we enrolled 25 patients who underwent internal mammary artery perforator (IMAP) flap reconstruction after salvage TL or LP. We performed retrospective review of clinical charts to collect information such as history, timing of reconstruction, type of defect, follow-up, donor and recipient site complications, and overall flap survival (OFS) rate. Three years overall survival (OS), relapse-free survival (RFS), and disease-specific survival (DSS) were calculated. RESULTS The OFS rate was 95%. One partial flap necrosis was recorded. No donor-site complications were found. The mean follow-up was 18 months. Three years OS was 44%, RFS was 47%, and DSS was 54%. CONCLUSIONS IMAP flap appears to be safe, versatile, and easy to harvest, with minimal donor site morbidity. It is a reliable option in Head&Neck reconstruction, in salvage surgery as well.
Databáze: OpenAIRE
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