Bare dorsal thoracic fascial flap for esophageal defects: an experimental study with dogs

UGURLU K., KARSİDAG T., HUTHUT I., KARSİDAG S., ÖZER K., SACAK B., ...Daha Fazla

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, cilt.26, sa.6, ss.1682-1689, 2012 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 6
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1007/s00464-011-2093-3
  • Dergi Adı: SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1682-1689
  • Anahtar Kelimeler: Bare dorsal thoracic fascial flap, Epithelialization, dEsophageal defect, PHARYNGOESOPHAGEAL RECONSTRUCTION, EPITHELIALIZATION PROCESS, ORAL RECONSTRUCTION, CAVITY
  • Akdeniz Üniversitesi Adresli: Hayır

Özet

Background Reconstruction of esophageal defects has challenged reconstructive surgeons for a long time. Problems that affect the continuity of the orogastic tract influence the patient's quality of life and general health. Bare free fascial flaps are used to restore soft tissue defects of the oral cavity because they provide thin, pliable tissues with a high capacity for epithelialization to preserve the local anatomy. An experimental study was planned to investigate reconstruction of anterior cervical esophageal defects using a pedicled dorsal thoracic fascial flap.
Abstract

Background Reconstruction of esophageal defects has challenged reconstructive surgeons for a long time. Problems that affect the continuity of the orogastic tract influence the patient's quality of life and general health. Bare free fascial flaps are used to restore soft tissue defects of the oral cavity because they provide thin, pliable tissues with a high capacity for epithelialization to preserve the local anatomy. An experimental study was planned to investigate reconstruction of anterior cervical esophageal defects using a pedicled dorsal thoracic fascial flap. 

Methods Eight hybrid dogs were used in the study. All operations were planned in three steps and performed with the animals under general anesthesia. For the two-layered reconstruction, the bare dorsal thoracic fascial flap was harvested and adapted like a patch to the defect. 

Results No partial or total flap loss was observed. On postoperative day 20 surgery, a complete epithelial lining on the same plane as the esophageal mucosa was observed over the flap tissue. A 4- to 5-mm longitudinal scar that did not form even a minimal stricture in any dog also was observed. No significant changes from postoperative day 20 to postoperative days 40 and 60 were observed. 

Conclusion Bare fascial flaps in the oral cavity heal with spontaneous epithelialization and with no need for skin and mucosal grafts. Fascial flaps are easy to harvest and do not cause any functional loss because they are nonfunctional units. Their thin constitution helps the surgeon to shape the tissue and even form tubed flaps.