Abstract
Objective: Salvage pharyngolaryngeal surgery can often cause severe complications. We applied surgical techniques, including pectoralis major myocutaneous flap (PMMCF) or deltopectoral flap (DPF) and some additional techniques, and could reduce the PCF and severe complications. Herein, we report the usefulness of our surgical techniques in salvage pharyngolaryngeal surgery.
Method: This retrospective study was based on a review between 2001 and 2010. Additional surgical techniques were applied since 2008. Our surgical techniques included covering with PMMC or DP, leakage test, thyroid lobe preserving, and suturing the tracheal cartilage to sternoclavicular joint. The complication rate and PCF rate were analyzed.
Results: Salvage surgeries were undergone in 36 patients between 2001 and 2008. The wound complication rate was 30.5%. The incidence of PCF was 22.2%. In the chemoradiation group, 3 out of the 5 PCF cases suffered severe bleeding. Since 2008 salvage surgery was performed in 18 patients. The wound complication rate was 28% and PCF rate was 5.5%. We had no lethal complication, such as carotid rupture.
Conclusion: We could not reduce the complication rate because the complications of flap were increased. However, we could reduce the PCF rate and lethal complications using additional surgical techniques. We must improve the surgical techniques to reduce the risk of complications in salvage pharyngolaryngeal surgery in the era of organ preservation therapy.
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