Comparison of Outcomes Between Free Ileocolonic and Tube-Shaped ALT Fasciocutaneous Flaps in Total Hypopharyngeal Defect Reconstruction.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-09-29 DOI:10.1002/hed.70051

Jian-Xun Chen, Ta-I Wang, Shane D Morrison, Mei-Chen Lin, Pin-Keng Shih

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Abstract

Objectives: This study compares the outcomes of free ileocolonic and tube-shaped anterolateral thigh (ALT) fasciocutaneous flaps in reconstructing total hypopharyngeal defects.

Methods: A retrospective analysis was conducted on 76 patients who underwent reconstruction with either an ileocolonic flap (n = 20) or a tube-shaped ALT flap (n = 56) between 2011 and 2021. Primary outcomes included dietary tolerance at 1 and 3 years, pharyngocutaneous fistula rates, and survival. Statistical analyses assessed group differences in complications and dietary restrictions.

Results: The ileocolonic flap group demonstrated superior dietary outcomes at 1 and 3 years (90% vs. 62.5% and 90% vs. 51.4%, respectively) but had a higher fistula rate (25% vs. 7.1%, p = 0.048). No significant differences in survival were observed between the groups.

Conclusion: The ileocolonic flap offers better long-term dietary outcomes despite higher early fistula rates. Further research is recommended to optimize flap selection for hypopharyngeal reconstruction.

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游离回结肠与管状ALT筋膜皮瓣在全下咽缺损重建中的效果比较。

目的：比较游离回结肠和管状股前外侧筋膜皮瓣重建全下咽缺损的效果。方法：回顾性分析2011年至2021年间76例采用回肠结肠皮瓣（n = 20）或管状ALT皮瓣（n = 56）重建的患者。主要结局包括1年和3年的饮食耐受性、咽皮瘘发生率和生存率。统计分析评估了并发症和饮食限制的组间差异。结果：回肠结肠皮瓣组在1年和3年表现出更好的饮食结果（分别为90%比62.5%和90%比51.4%），但瘘率更高（25%比7.1%,p = 0.048）。两组间生存率无显著差异。结论：尽管早期瘘管发生率较高，但回肠结肠皮瓣提供了更好的长期饮食结果。建议进一步研究优化下咽重建皮瓣的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.