Bare Serratus Anterior Free Flap in the Reconstruction of the Partial Pharyngoesophageal Defect

Ugurlu K., Karsidag T., Akcal A., Karsidag S., Yazar M., Seven H.

JOURNAL OF CRANIOFACIAL SURGERY, cilt.22, sa.3, ss.1010-1012, 2011 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 3
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1097/scs.0b013e3182101567
  • Dergi Adı: JOURNAL OF CRANIOFACIAL SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1010-1012
  • Anahtar Kelimeler: Serratus anterior fascial free flap, partial cervicoesophageal defect, ANTEROLATERAL THIGH FLAP, FASCIOCUTANEOUS FREE FLAPS, FOREARM-FREE FLAP, FUNCTIONAL OUTCOMES, ESOPHAGEAL RECONSTRUCTION, EPITHELIALIZATION PROCESS, ORAL RECONSTRUCTION, CERVICAL ESOPHAGUS, FASCIAL FLAPS, JEJUNAL FLAP
  • Akdeniz Üniversitesi Adresli: Hayır

Özet

Reconstruction of defects of the cervical esophagus is a challenge in head and neck surgery. Several methods have been used: flaps with local tissues, pharyngogastric anastomosis, deltopectoral skin flaps, skin muscle transplant from the pectoralis major, and microvascularized free skin fascial and small intestine flaps. A 81-year-old patient who has a partial pharyngoesophageal defect after resection of laryngeal carcinoma underwent reconstruction with bare serratus anterior fascial free flap. The subscapular artery and vein were anastomosed to the superior thyroid artery and vein. The patient's postoperative recovery went uneventfully. In the endoscopic examination, the defect was completely covered with native mucosa 8 weeks after surgery, and also, there were no stricture and fistula tract in the reconstructed area.
Abstract

Reconstruction of defects of the cervical esophagus is a challenge in head and neck surgery. Several methods have been used: flaps with local tissues, pharyngogastric anastomosis, deltopectoral skin flaps, skin muscle transplant from the pectoralis major, and microvascularized free skin fascial and small intestine flaps. A 81-year-old patient who has a partial pharyngoesophageal defect after resection of laryngeal carcinoma underwent reconstruction with bare serratus anterior fascial free flap. The subscapular artery and vein were anastomosed to the superior thyroid artery and vein. The patient's postoperative recovery went uneventfully. In the endoscopic examination, the defect was completely covered with native mucosa 8 weeks after surgery, and also, there were no stricture and fistula tract in the reconstructed area. 

Serratus fascial flap is a thin and pliable flap with good and reliable vascularity; it can be used in the reconstruction of partial cervical esophageal defect with its long pedicle. Serratus fascial flap can provide significant epithelialization that cannot be differentiated from native esophagus. We propose that serratus fascial free flap is an important alternative in esophageal reconstructions because it creates minimal donor-site morbidity and it can easily adapt to the defect.