Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_892_Библиотеки_им_академика_М_И_Перельмана
.pdf
8 Pharyngoesophageal Reconstruction
https://t.me/medicina_free
161
demonstrated high rates of severe late toxicity (43%) with older age, advanced T
stage, and laryngeal/hypopharyngeal primaries identied as independent risk factors on multivariate analysis [134]. While patients who undergo laryngectomy are
no longer at risk of aspiration, restoration of functional swallow can be a challenge,
particularly in the salvage setting. Furthermore, while much has been published in
the literature regarding the impact of reconstructive techniques of development of
pharyngocutaneous stula, the data describing functional outcomes are relatively sparse.
Postoperative dysphagia following total laryngectomy is quite common with up
to 72–87% of patients reporting dysphagia after surgery, which may be related to
alterations in contractility of the residual pharynx and dysfunction from prior treatment [135]. Similarly, rates of gastrostomy tube dependence vary with retrospective
series report rates of up to 57% after salvage total laryngectomy [49, 50, 81, 136].
Worley etal. found patients who had advanced disease (pT4 or pN2+) or underwent
re-irradiation to be at high risk of long-term gastrostomy dependence [135].
Comparison of gastrostomy tube rates among different reconstructive options is
challenging as operative technique varies greatly among surgeons and institutions,
and numerous factors unrelated to the reconstruction inuence the need for gastrostomy [137]. Nonetheless, many patients are able to regain some degree of swallowing function. Hutcheson etal. reported a series of 23 patients undergoing salvage
laryngectomy for laryngopharyngeal dysfunction and found that all patients tolerated oral intake with only 17% of patients requiring supplemental enteral nutrition
postoperatively despite 74% being gastrostomy dependent prior to surgery.
Strictures occur relatively frequently after laryngectomy, with rates ranging from
13% to 50% [138]. Strictures are particularly common in tubed aps (up to 50%),
likely due to the circumferential repair at the esophageal anastomosis [81, 137].
Sweeny etal. found that patients undergoing primary closure had lower rates of
stricture than those who underwent RFFF reconstruction, with similar rates of stricture regardless of prior radiation [138]. In their series, they also found that patients
who required only a single dilation had better dietary outcomes than those who
required serial dilations [138]. Yu et al. published a series of 114 patients who
underwent reconstruction with ALT free aps and reported a much lower stricture
rate (6%) including only a 9% stricture rate in patients with circumferential defects
[51]. In their series, a vertical incision was carried along the anterior esophageal
wall to increase the diameter of the anastomosis, which has contributed to their
lower stricture rate.
References
1. SEER*Explorer: an interactive website for SEER cancer statistics [Internet]. Surveillance
Research Program, N.C.I.C.S.A.f.h.s.c.g.
2. Siegel RL, etal. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33.
3. Wolf GT, etal. Induction chemotherapy plus radiation compared with surgery plus radiation
in patients with advanced laryngeal cancer. N Engl J Med. 1991;324(24):1685–90.
162
https://t.me/medicina_free
4. Forastiere AA, etal. Concurrent chemotherapy and radiotherapy for organ preservation in
advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091–8.
5. Forastiere AA, etal. Long-term results of RTOG 91-11: a comparison of three nonsurgical
treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J
Clin Oncol. 2013;31(7):845–52.
6. Rosenthal DI, et al. Long-term outcomes after surgical or nonsurgical initial therapy
for patients with T4 squamous cell carcinoma of the larynx: a 3-decade survey. Cancer.
2015;121(10):1608–19.
7. Patel UA, etal. Impact of pharyngeal closure technique on stula after salvage laryngectomy.
JAMA Otolaryngol Head Neck Surg. 2013;139(11):1156–62.
8. Shah MA, etal. Treatment of locally advanced esophageal carcinoma: ASCO guideline. J
Clin Oncol. 2020;38(23):2677–94.
9. Graboyes EM, etal. Effect of time to initiation of postoperative radiation therapy on survival
in surgically managed head and neck cancer. Cancer. 2017;123(24):4841–50.
10. Ganly I, et al. Postoperative complications of salvage total laryngectomy. Cancer.
2005;103(10):2073–81.
11. Weber RS, etal. Outcome of salvage total laryngectomy following organ preservation therapy: the radiation therapy oncology group trial 91-11. Arch Otolaryngol Head Neck Surg.
2003;129(1):44–9.
12. Kierzek A, et al. The rst polish total laryngectomies. Contemp Oncol (Pozn).
2013;17(6):473–6.
13. Ceachir O, Hainarosie R, Zainea V. Total laryngectomy—past, present, future. Maedica.
2014;9(2):210–6.
14. Matev B, etal. Losing one’s voice to save One's life: a brief history of laryngectomy. Cureus.
2020;12(6):e8804.
15. Hui Y, etal. Primary closure of pharyngeal remnant after total laryngectomy and partial pharyngectomy: how much residual mucosa is sufcient? Laryngoscope. 1996;106(4):490–4.
16. Ragbir M, Brown JS, Mehanna H.Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol.
2016;130(S2):S191–7.
17. Yeh DH, Sahovaler A, Fung K. Reconstruction after salvage laryngectomy. Oral Oncol.
2017;75:22–7.
18. Chotipanich A. Total laryngectomy: a review of surgical techniques. Cureus.
2021;13(9):e18181.
19. Avci H, Karabulut B.Is it important which suturing technique used for pharyngeal mucosal
closure in total laryngectomy? Modied continuous Connell suture may decrease pharyngocutaneous stula. Ear Nose Throat J. 2020;99(10):664–70.
20. Haksever M, etal. Modied continuous mucosal Connell suture for the pharyngeal closure
after total laryngectomy: zipper suture. Clin Exp Otorhinolaryngol. 2015;8(3):281–8.
21. Thrasyvoulou G, et al. Horizontal (vs. vertical) closure of the neo-pharynx is associated with superior postoperative swallowing after total laryngectomy. Ear Nose Throat
J. 2018;97(4–5):E31–5.
22. Davis RK, etal. The anatomy and complications of “T” versus vertical closure of the hypopharynx after laryngectomy. Laryngoscope. 1982;92(1):16–22.
23. van der Kamp MF, Rinkel RNPM, Eerenstein SEJ. The inuence of closure technique in
total laryngectomy on the development of a pseudo-diverticulum and dysphagia. Eur Arch
Otorhinolaryngol. 2017;274(4):1967–73.
24. Maclean J, etal. Impact of a laryngectomy and surgical closure technique on swallow biomechanics and dysphagia severity. Otolaryngol Head Neck Surg. 2011;144(1):21–8.
25. Walton B, et al. Post-laryngectomy stricture and pharyngocutaneous stula: review of
techniques in primary pharyngeal reconstruction in laryngectomy. Clin Otolaryngol.
2018;43(1):109–16.
26. Deniz M, Ciftci Z, Gultekin E. Pharyngoesophageal suturing technique may decrease the
incidence of pharyngocutaneous stula following total laryngectomy. Surg Res Pract.
2015;2015:363640.
R. Y. Wang et al.
8 Pharyngoesophageal Reconstruction
https://t.me/medicina_free
27. Sofferman RA, Voronetsky I.Use of the linear stapler for pharyngoesophageal closure after
total laryngectomy. Laryngoscope. 2000;110(8):1406–9.
28. Sansa-Perna A, etal. Pharyngeal closure after a total laryngectomy: mechanical versus manual technique. J Laryngol Otol. 2020;134(7):626–31.
29. Lee Y-C, etal. Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: a systematic review and meta-analysis. Clin Otolaryngol. 2021;46(4):692–8.
30. Smith SR, Genden EM, Urken ML. Endoscopic stapling technique for the treatment of
Zenker diverticulum vs standard open-neck technique: a direct comparison and charge analysis. Arch Otolaryngol Head Neck Surg. 2002;128(2):141–4.
31. Wookey H.The surgical treatment of carcinoma of the hypopharynx and the oesophagus. Br
J Surg. 1948;35(139):249–66.
32. Patel RS, etal. Circumferential pharyngeal reconstruction: history, critical analysis of techniques, and current therapeutic recommendations. Head Neck. 2010;32(1):109–20.
33. Bakamjian VY, Long M, Rigg B.Experience with the medially based deltopectoral ap in
reconstructuve surgery of the head and neck. Br J Plast Surg. 1971;24(2):174–83.
34. Andrews BT, etal. Deltopectoral ap revisited in the microvascular era: a single-institution
10-year experience. Ann Otol Rhinol Laryngol. 2006;115(1):35–40.
35. Yu P, Roblin P, Chevray P.Internal mammary artery perforator (IMAP) ap for tracheostoma
reconstruction. Head Neck. 2006;28(8):723–9.
36. Ibrahim A, etal. The deltopectoral ap revisited: the internal mammary artery perforator ap.
J Craniofac Surg. 2016;27(2):e189–92.
37. Shayan R, Syme DY, Grinsell D.The IMAP ap for pharygoesophageal reconstruction following stricture release. J Plast Reconstr Aesthet Surg. 2012;65(6):810–3.
38. Mirghani H, etal. Pharyngotracheal stula closure using the internal mammary artery perforator Island ap. Laryngoscope. 2014;124(5):1106–11.
39. Ariyan S.The pectoralis major myocutaneous ap. A versatile ap for reconstruction in the
head and neck. Plast Reconstr Surg. 1979;63(1):73–81.
40. Burke MS, etal. Pectoralis major myocutaneous ap for reconstruction of circumferential
pharyngeal defects. Ann Plast Surg. 2013;71(6):649–51.
41. Righini C, et al. The pectoralis myofascial ap in pharyngolaryngeal surgery after radiotherapy. Eur Arch Otorhinolaryngol. 2005;262(5):357–61.
42. Patel UA, Keni SP.Pectoralis myofascial ap during salvage laryngectomy prevents pharyngocutaneous stula. Otolaryngol Head Neck Surg. 2009;141(2):190–5.
43. Comert E, etal. Pectoralis major myofascial ap in salvage laryngectomy. J Laryngol Otol.
2014;128(8):714–9.
44. Fabian RL.Reconstruction of the laryngopharynx and cervical esophagus. Laryngoscope.
1984;94(10):1334–50.
45. Spriano G, Piantanida R, Pellini R.Hypopharyngeal reconstruction using pectoralis major
myocutaneous ap and pre-vertebral fascia. Laryngoscope. 2001;111(3):544–7.
46. Richmon JD, Brumund KT.Reconstruction of the hypopharynx: current trends. Curr Opin
Otolaryngol Head Neck Surg. 2007;15(4):208–12.
47. Teknos TN, et al. Free tissue reconstruction of the hypopharynx after organ preservation
therapy: analysis of wound complications. Laryngoscope. 2001;111(7):1192–6.
48. Disa JJ, etal. Microvascular reconstruction of the hypopharynx: defect classication, treatment algorithm, and functional outcome based on 165 consecutive cases. Plast Reconstr
Surg. 2003;111(2):652–60. discussion 661–3.
49. Sandulache VC, etal. Salvage total laryngectomy after external-beam radiotherapy: a 20-year
experience. Head Neck. 2016;38(Suppl 1(Suppl 1)):E1962–8.
50. Chen DW, etal. Free ap inset techniques in salvage Laryngopharyngectomy repair: impact
on stula formation and function. Laryngoscope. 2021;131(3):E875–81.
51. Yu P, etal. Pharyngoesophageal reconstruction with the anterolateral thigh ap after total
laryngopharyngectomy. Cancer. 2010;116(7):1718–24.
52. Microvascular Committee of the American Academy of Otolaryngology-Head & Neck
Surgery. Salvage laryngectomy and laryngopharyngectomy: multicenter review of outcomes
associated with a reconstructive approach. Head Neck. 2019;41(1):16–29.
163
164
https://t.me/medicina_free
53. Guimarães AV, et al. Efcacy of pectoralis major muscle ap for pharyngocutaneous stula prevention in salvage total laryngectomy: a systematic review. Head Neck.
2016;38(S1):E2317–21.
54. Deschler DG, et al. Quantitative and qualitative analysis of tracheoesophageal voice after
pectoralis major ap reconstruction of the neopharynx. Otolaryngol Head Neck Surg.
1998;118(6):771–6.
55. Pallua N, Magnus Noah E. The tunneled supraclavicular Island ap: an optimized technique for head and neck reconstruction. Plast Reconstr Surg. 2000;105(3):842–51. discussion 852–4.
56. Emerick KS, Herr MA, Deschler DG. Supraclavicular ap reconstruction following total
laryngectomy. Laryngoscope. 2014;124(8):1777–82.
57. Makiese O, etal. Huge proliferating trichilemmal tumors of the scalp: report of six cases.
Plast Reconstr Surg. 2010;126(1):18e–9e.
58. Liu PH, Chiu ES.Supraclavicular artery ap: a new option for pharyngeal reconstruction.
Ann Plast Surg. 2009;62(5):497–501.
59. Taylor R, Sionis S, Varley I.Spiralised supraclavicular artery Island ap for total pharyngeal
reconstruction: a technical note. Br J Oral Maxillofac Surg. 2021;59(2):242–3.
60. Seidenberg B, etal. Immediate reconstruction of the cervical esophagus by a revascularized
isolated jejunal segment. Ann Surg. 1959;149(2):162–71.
61. Nagel TH, Hayden RE.Advantages and limitations of free and pedicled aps in reconstruction
of pharyngoesophageal defects. Curr Opin Otolaryngol Head Neck Surg. 2014;22(5):407–13.
62. Corbitt C, et al. Free ap failure in head and neck reconstruction. Head Neck.
2014;36(10):1440–5.
63. Ligh CA, etal. An analysis of early oncologic head and neck free ap reoperations from the
2005-2012 ACS-NSQIP dataset. J Plast Surg Hand Surg. 2016;50(2):85–92.
64. Yang GF, etal. Forearm free skin ap transplantation: a report of 56 cases. 1981. Br J Plast
Surg. 1997;50(3):162–5.
65. Megerle K, Sauerbier M, Germann G. The evolution of the pedicled radial forearm ap.
Hand. 2010;5(1):37–42.
66. Foissac R, etal. Coverage of tendon exposure after radial forearm free ap by the dorsoulnar
artery perforator ap. Otolaryngol Head Neck Surg. 2017;156(5):822–7.
67. Hartwig S, et al. Treatment of wound healing disorders of radial forearm free ap
donor sites using cold atmospheric plasma: a proof of concept. J Oral Maxillofac Surg.
2017;75(2):429–35.
68. Lovie MJ, Duncan GM, Glasson DW.The ulnar artery forearm free ap. Br J Plast Surg.
1984;37(4):486–92.
69. Huang JJ, etal. Anatomical basis and clinical application of the ulnar forearm free ap for
head and neck reconstruction. Laryngoscope. 2012;122(12):2670–6.
70. Huang AT, Day TA.Double paddle ulnar perforator free ap in reconstruction of throughand- through and stulous defects of the head and neck. Laryngoscope. 2017;127(6):1302–5.
71. Harii K, etal. Pharyngoesophageal reconstruction using a fabricated forearm free ap. Plast
Reconstr Surg. 1985;75(4):463–76.
72. Urken ML, etal. A modied design of the buried radial forearm free ap for use in oral cavity
and pharyngeal reconstruction. Arch Otolaryngol Head Neck Surg. 1994;120(11):1233–9.
73. Pellini R, etal. External monitor for buried free aps in head and neck reconstructions. Acta
Otorhinolaryngol Ital. 2006;26(1):1–6.
74. Kuriakose MA, et al. Sensate radial forearm free aps in tongue reconstruction. Arch
Otolaryngol Head Neck Surg. 2001;127(12):1463–6.
75. Ahmed A, etal. Use of double skin paddle for pharyngoesophageal reconstruction using
tubed radial forearm free ap. Br J Oral Maxillofac Surg. 2014;52(7):661–3.
76. Machado RA, Moubayed SP, Urken ML.Repair of pharyngoesophageal stenosis and a tracheoesophageal stula using a dual-paddled radial forearm free ap: ap design and surgical
technique. Laryngoscope. 2017;127(9):2081–4.
R. Y. Wang et al.
8 Pharyngoesophageal Reconstruction
https://t.me/medicina_free
77. Sinclair CF, etal. Primary versus delayed tracheoesophageal puncture for laryngopharyngectomy with free ap reconstruction. Laryngoscope. 2011;121(7):1436–40.
78. Kelly KE, Anthony JP, Singer M. Pharyngoesophageal reconstruction using the radial
forearm fasciocutaneous free ap: preliminary results. Otolaryngol Head Neck Surg.
1994;111(1):16–24.
79. Azizzadeh B, et al. Radial forearm free ap pharyngoesophageal reconstruction.
Laryngoscope. 2001;111(5):807–10.
80. Cho BC, etal. Pharyngoesophageal reconstruction with a tubed free radial forearm ap. J
Reconstr Microsurg. 1998;14(8):535–40.
81. Withrow KP, etal. Free tissue transfer to manage salvage laryngectomy defects after organ
preservation failure. Laryngoscope. 2007;117(5):781–4.
82. Song YG, Chen GZ, Song YL.The free thigh ap: a new free ap concept based on the septocutaneous artery. Br J Plast Surg. 1984;37(2):149–59.
83. Park CW, Miles BA.The expanding role of the anterolateral thigh free ap in head and neck
reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2011;19(4):263–8.
84. Marmuse JP, Guedon C, Koka VN.Gastric tube transposition for cancer of the hypopharynx
and cervical oesophagus. J Laryngol Otol. 1994;108(1):33–7.
85. Butskiy O, Anderson DW, Prisman E. Management algorithm for failed gastric pull up
reconstruction of laryngopharyngectomy defects: case report and review of the literature. J
Otolaryngol Head Neck Surg. 2016;45(1):41.
86. Tsai WS, Levy RM, Luketich JD.Technique of minimally invasive Ivor Lewis esophagectomy. Oper Tech Thorac Cardiovasc Surg. 2009;14(3):176–92.
87. Liebermann-Meffert DM, Meier R, Siewert JR.Vascular anatomy of the gastric tube used for
esophageal reconstruction. Ann Thorac Surg. 1992;54(6):1110–5.
88. Jiang H, etal. Risk factors for anastomotic complications after radical McKeown esophagectomy. Ann Thorac Surg. 2021;112(3):944–51.
89. Hagens ERC, etal. Risk factors and consequences of anastomotic leakage after esophagectomy for cancer. Ann Thorac Surg. 2021;112(1):255–63.
90. Van Daele E, etal. Risk factors and consequences of anastomotic leakage after Ivor Lewis
oesophagectomy†. Interact Cardiovasc Thorac Surg. 2016;22(1):32–7.
91. Kassis ES, etal. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg. 2013;96(6):1919–26.
92. Zhang W, etal. Gastric-tube versus whole-stomach esophagectomy for esophageal cancer: a
systematic review and meta-analysis. PLoS One. 2017;12(3):e0173416.
93. Yu P, etal. Comparison of clinical and functional outcomes and hospital costs following pharyngoesophageal reconstruction with the anterolateral thigh free ap versus the jejunal ap.
Plast Reconstr Surg. 2006;117(3):968–74.
94. Kamiyama R, etal. A clinical study of pharyngolaryngectomy with total esophagectomy:
postoperative complications, countermeasures, and prognoses. Otolaryngol Head Neck Surg.
2015;153(3):392–9.
95. Triboulet JP, et al. Surgical management of carcinoma of the hypopharynx and cervical
esophagus: analysis of 209 cases. Arch Surg. 2001;136(10):1164–70.
96. Heger P, etal. Gastric preconditioning in advance of esophageal resection-systematic review
and meta-analysis. J Gastrointest Surg. 2017;21(9):1523–32.
97. Takeda FR, etal. Supercharged cervical anastomosis for esophagectomy and gastric pull-up.
J Thorac Cardiovasc Surg. 2021;162(3):688–697.e3.
98. Huang PM, et al. Supercharged reversed gastric tube technique: a microvascular anastomosis procedure for pharyngo-oesophageal reconstruction after total laryngopharyngooesophagectomy. Eur J Cardiothorac Surg. 2013;44(2):258–62.
99. Thomas P, et al. Colon interposition for esophageal replacement: current indications and
long-term function. Ann Thorac Surg. 1997;64(3):757–64.
100. DeMeester TR, et al. Indications, surgical technique, and long-term functional results of
colon interposition or bypass. Ann Surg. 1988;208(4):460–74.
165
166
https://t.me/medicina_free
101. Sakorafas GH, Zouros E, Peros G.Applied vascular anatomy of the colon and rectum: clinical implications for the surgical oncologist. Surg Oncol. 2006;15(4):243–55.
102. Lees W.Colonic replacement after pharyngolaryngectomy. Br J Surg. 1967;54(6):541–7.
103. Bakshi A, Sugarbaker DJ, Burt BM.Alternative conduits for esophageal replacement. Ann
Cardiothorac Surg. 2017;6(2):137–43.
104. Rice T. Colon replacement. In: Pearson F, Deslauriers J, Ginsberg R, editors. Esophageal
surgery. NewYork: Churchill Livingstone; 1995. p.761–74.
105. Mansour KA, Bryan FC, Carlson GW. Bowel interposition for esophageal replacement:
twenty-ve-year experience. Ann Thorac Surg. 1997;64(3):752–6.
106. Shirakawa Y, et al. Colonic interposition and supercharge for esophageal reconstruction.
Langenbeck’s Arch Surg. 2006;391(1):19–23.
107. Saeki H, etal. Esophageal replacement by colon interposition with microvascular surgery
for patients with thoracic esophageal cancer: the utility of superdrainage. Dis Esophagus.
2013;26(1):50–6.
108. Davis PA, Law S, Wong J.Colonic interposition after esophagectomy for cancer. Arch Surg.
2003;138(3):303–8.
109. Kesler KA, etal. “Supercharged” isoperistaltic colon interposition for long-segment esophageal reconstruction. Ann Thorac Surg. 2013;95(4):1162–8. discussion 1168–9.
110. Ninomiya I, et al. Feasibility of esophageal reconstruction using a pedicled jejunum with
intrathoracic esophagojejunostomy in the upper mediastinum for esophageal cancer. Gen
Thorac Cardiovasc Surg. 2014;62(10):627–34.
111. Popovici Z.A new philosophy in esophageal reconstruction with colon. Thirty-years experience. Dis Esophagus. 2003;16(4):323–7.
112. Reslinger V, etal. Esophageal reconstruction by colon interposition after esophagectomy for
cancer analysis of current indications, operative outcomes, and long-term survival. J Surg
Oncol. 2016;113(2):159–64.
113. Knezević JD, etal. Colon interposition in the treatment of esophageal caustic strictures: 40
years of experience. Dis Esophagus. 2007;20(6):530–4.
114. Cerfolio RJ, et al. Esophageal replacement by colon interposition. Ann Thorac Surg.
1995;59(6):1382–4.
115. Greene CL, etal. Long-term quality of life and alimentary satisfaction after esophagectomy
with colon interposition. Ann Thorac Surg. 2014;98(5):1713–9. discussion 1719–20.
116. Longmire WP Jr, Ravitch MM.A new method for constructing an articial esophagus. Ann
Surg. 1946;123:819–35.
117. Gaur P, Blackmon SH.Jejunal graft conduits after esophagectomy. J Thorac Dis. 2014;6(Suppl
3(Suppl 3)):S333–40.
118. Blackmon SH, etal. Supercharged pedicled jejunal interposition for esophageal replacement:
a 10-year experience. Ann Thorac Surg. 2012;94(4):1104–11; discussion 1111–3.
119. Swisher SG, Hofstetter WL, Miller MJ.The supercharged microvascular jejunal interposition. Semin Thorac Cardiovasc Surg. 2007;19(1):56–65.
120. Rice D, Yu P. Use of supercharged Jejunal ap for esophageal reconstruction. Oper Tech
Thorac Cardiovasc Surg. 2010;15:243–57.
121. Poh M, etal. Technical challenges of total esophageal reconstruction using a supercharged
jejunal ap. Ann Surg. 2011;253(6):1122–9.
122. DeMeester SR.Colonic interposition for benign disease. Oper Tech Thorac Cardiovasc Surg.
2006;11(3):232–49.
123. Zheng YZ, et al. Comparison between different reconstruction routes in esophageal squamous cell carcinoma. World J Gastroenterol. 2012;18(39):5616–21.
124. de Delva PE, etal. Surgical management of failed colon interposition. Eur J Cardiothorac
Surg. 2008;34(2):432–7; discussion 437.
125. Motoyama S, etal. Surgical outcome of colon interposition by the posterior mediastinal route
for thoracic esophageal cancer. Ann Thorac Surg. 2007;83(4):1273–8.
R. Y. Wang et al.
8 Pharyngoesophageal Reconstruction
https://t.me/medicina_free
126. Lorenz KJ.Rehabilitation after total laryngectomy-a tribute to the pioneers of voice restoration in the last two centuries. Front Med. 2017;4:81.
127. Robbins J.Acoustic differentiation of laryngeal, esophageal, and tracheoesophageal speech.
J Speech Hear Res. 1984;27(4):577–85.
128. Moukarbel RV, etal. Voice-related quality of life (V-RQOL) outcomes in laryngectomees.
Head Neck. 2011;33(1):31–6.
129. Panwar A, etal. Impact of primary tracheoesophageal puncture on outcomes after total laryngectomy. Otolaryngol Head Neck Surg. 2018;158(1):103–9.
130. Gitomer SA, etal. Inuence of timing, radiation, and reconstruction on complications and
speech outcomes with tracheoesophageal puncture. Head Neck. 2016;38(12):1765–71.
131. Lewin JS, et al. Device life of the tracheoesophageal voice prosthesis revisited. JAMA
Otolaryngol Head Neck Surg. 2017;143(1):65–71.
132. Hutcheson KA, etal. Outcomes and adverse events of enlarged tracheoesophageal puncture
after total laryngectomy. Laryngoscope. 2011;121(7):1455–61.
133. Dewey EH, etal. Reconstruction of expanding tracheoesophageal stulae in post-radiation
therapy patients who undergo total laryngectomy with a bipaddled radial forearm free ap:
report of 8 cases. Head Neck. 2016;38(S1):E172–8.
134. Machtay M, et al. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol.
2008;26(21):3582–9.
135. Worley ML, etal. Factors associated with gastrostomy tube dependence following salvage
total laryngectomy with microvascular free tissue transfer. Head Neck. 2019;41(4):865–70.
136. Chen WF, et al. Outcomes of anterolateral thigh ap reconstruction for salvage laryngopharyngectomy for hypopharyngeal cancer after concurrent chemoradiotherapy. PLoS One.
2013;8(1):e53985.
137. Hanasono MM, etal. Closure of laryngectomy defects in the age of chemoradiation therapy.
Head Neck. 2012;34(4):580–8.
138. Sweeny L, etal. Incidence and outcomes of stricture formation postlaryngectomy. Otolaryngol
Head Neck Surg. 2012;146(3):395–402.
167
Chapter 9
https://t.me/medicina_free
Trends inMicrovascular Surgery
AndrewBeech andJustineMoe
Introduction
The eld of microvascular surgery has evolved in the past 150 years. In 1896,
American surgeon John Murphy performed the rst vascular anastomosis for repair
of a severed femoral artery following a gunshot wound to the lower extremity [1].
In 1902, Alexis Carrel described a triangulation of vessel technique for the end-toend arteriovenous anastomosis and is credited by many as the father of vascular
surgery [2]. In 1957, Seidenberg etal. performed the rst free tissue transfer, the
autotransplantation of a segment of jejunum for reconstruction of a pharyngolaryngectomy defect [3]. Jacobson and Suarez rst described use of the operative microscope for small vessel anastomosis in 1960 and coined the term “microsurgery” [4].
Subsequently, microvascular surgical techniques were utilized for digital transplantation and the rst toe-to-thumb transplantation in the 1960s [2] and the rst omental ap for scalp reconstruction in 1972 by McLean and Buncke [5]. Musculocutaneous
free aps were popularized in the 1970s, and osteocutaneous free aps were developed in the 1970s and 1980s, including the description of the bula free ap for
mandibular reconstruction by Hidalgo in 1989 [6].
Advances in the understanding of vascular anatomy, microsurgical technique,
preoperative imaging, and ap monitoring have led to an evolution in the predictability of free tissue transfer reconstruction [7]. At present, anastomotic and free
ap success rates range from 90% to 99%, with a shift in focus from ap survival to
optimizing the restoration of function and esthetics and minimizing donor site morbidity. Customizable reconstructive options are possible through the emergence of
A. Beech · J. Moe (*)
Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
Department of Oral and Maxillofacial Surgery, ThomasJeffersonUniversity,
Philadelphia, PA, USA
e-mail: andrew.beech@jefferson.edu; jusmoe@med.umich.edu
© The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
J. C. Melville et al. (eds.), Advancements and Innovations in OMFS, ENT, and
Facial Plastic Surgery, https://doi.org/10.1007/978-3-031-32099-6_9
169
170
https://t.me/medicina_free
A. Beech and J. Moe
supermicrosurgery, perforator aps, and free-style aps to optimize reconstructive
outcomes. In this chapter, we describe the current technologic innovations at the
disposal of the microvascular reconstructive surgeon for preoperative planning for
ap harvest, intraoperative microanastomosis and ap assessment, and postoperative ap monitoring.
Preoperative Donor Site Assessment
The preoperative characterization of donor site vascular anatomy is critical to ensure
safe harvest of the reconstructive ap. Preoperative imaging modalities for vascular
anatomy are particularly important for the assessment of vascular anatomy prior to
bula free ap harvest which blood supply to the distal lower extremity can be compromised following harvest in the setting of aberrant vascular anatomy or severe
peripheral vascular disease. Additionally, advances in imaging modalities over the
last 30years have allowed for detailed preoperative evaluation of cutaneous perforator localization as an adjunct to intraoperative identication (Fig.9.1), and perforasome assessment which has utility in the assessment of perforator aps.
Surgeons in the early 1990’s relied upon handheld Doppler ultrasound for perforator localization; however, this technique was found to have a high false-positive
rate and was less reliable when perforators were traveling transversely though fascial planes [8]. Modern imaging modalities including computed tomography angiography (CTA) and color Doppler ultrasonography are more accurate than the
handheld Doppler in perforator localization. Additional techniques for preoperative
perforator localization include thermography and indocyanine green angiography
(ICGA). ICGA is discussed in the following section.
ab
Fig. 9.1 (a) Intraoperative identication of septocutaneous perforators during bula free ap harvest. (b) Intraoperative identication of musculocutaneous perforators during anterolateral thigh
free ap harvest
9 Trends inMicrovascular Surgery
https://t.me/medicina_free
171
Computer Tomography Angiography (CTA)
CTA imaging allows for the acquisition of more than 1000 slices over single bolus
dose of IV contrast and uses multidetector and reformatting software to generate a
three-dimensional (3D) volumetric analysis. CTA provides detailed information
regarding vessel mapping and allows for evaluation of vessel size, course, and relationship to adjacent structures. Preoperative CTA is the standard of care for assessing vascular anatomy prior to bula free ap (Fig.9.2). Additionally, CTA is highly
accurate in identifying perforators as small as 0.3mm, with over 95% sensitivity
and 95% accuracy [9].
ab
Fig. 9.2 (a) Computed tomography angiography (CTA) showing two vessel runoff on the left
lower extremity with a diminutive anterior tibial artery. (b) CTA showing bilateral three vessel
runoff with the left lower extremity exhibiting a high takeoff of the tibioperoneal trunk
Соседние файлы в папке Библиотека им академика М.И. Перельмана