Iliocostalis Muscle Rotational Flap: A Novel Flap for Esophagopleural Fistula Repair

Autor: Arthur J. Nam, MD, MS, Joshua Yoon, MD, Eric M. Krause, MD, Adekunle I. Elegbede, MD, PhD, Shamus R. Carr, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Plastic and Reconstructive Surgery, Global Open, Vol 10, Iss 1, p e4007 (2022)
Druh dokumentu: article
ISSN: 2169-7574
00000000
DOI: 10.1097/GOX.0000000000004007
Popis: Summary:. Intrathoracic fistulas present major challenges to reconstructive surgeons. Reconstruction with muscle flaps have been shown to improve patient outcomes; however, there are patients for whom one or more of the commonly used muscle flaps is not available for several reasons. We describe the use of an iliocostalis muscle rotational flap for the repair of a caudally located esophagopleural fistula in the setting of definitive chemoradiotherapy for treatment of nonsmall-cell lung cancer and reirradiation with photons for local recurrence 5 years later. Our repair remained intact through the nearly 12-month follow-up period during which the patient tolerated a regular diet. This report demonstrates that the iliocostalis lumborum muscle is a viable option for repair of intrathoracic fistulas that are located in the distal esophagus, even in the setting of previous thoracotomy and radiation, and should be part of the reconstructive surgeon’s armamentarium in the management of intrathoracic fistulas.
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