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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Transaxillary thoracodorsal artery perforator flap: A versatile new technique for hypopharyngeal reconstruction
Journal of Reconstructive Microsurgery, Volume 30, No. 6, Year 2014
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Description
Introduction Reconstruction of the hypopharynx and cervical esophagus after tumor resection remains a challenging problem. Different techniques of reconstruction have been described for such defects. Although free flap reconstruction, including jejunum and fasciocutaneous flaps, has gained popularity for this complex defect, regional flaps are still in use worldwide. Patients and Methods We present our experience using the pedicled thoracodorsal artery perforator (TDAP) flap whereby only a small cuff of latissimus dorsi muscle around the perforators is harvested. The remaining muscle with its nerve supply is preserved. The flap is delivered to the neck through the cervicoaxillary tunnel. It was used as a complete tube in six patients and with an additional attached skin island for reconstruction of the neck skin in another four patients. Results A total of 11 TDAP flaps were used for reconstruction in 10 patients. All flaps survived except in one patient who suffered from a complete flap loss. This was salvaged by another TDAP flap from the contralateral side. Partial sloughing of the outer part of the pedicled TDAP occurred in one other patient. Pharyngeal fistulas developed in another two patients and eventually healed spontaneously. All patients resumed an oral diet within 2 weeks except two with fistulas. All patients resumed their shoulder active range of motion within 3 weeks. Conclusion The transaxillary TDAP flap is an ideal technique for hypopharyngeal reconstruction. It offers the advantages of free fasciocutaneous flaps, has a wide arc of rotation, a relatively larger flap dimension, a reliable vascular pedicle, and acceptable donor site morbidity. © 2014 by Thieme Medical Publishers, Inc.
Authors & Co-Authors
Amin, Ayman Abdel Wahab
Egypt, Giza
National Cancer Institute
Rifaat, Mohammed Ahmed
Egypt, Giza
National Cancer Institute
Ellabban, Mohamed A.
Egypt, Ismailia
Faculty of Medicine
Zedan, Mohamed
Egypt, Giza
National Cancer Institute
Bassiouny, Mahmoud M.
Egypt, Giza
National Cancer Institute
Statistics
Citations: 11
Authors: 5
Affiliations: 2
Identifiers
Doi:
10.1055/s-0034-1376532
ISSN:
0743684X
e-ISSN:
10988947
Research Areas
Cancer
Health System And Policy