Anterolateral thigh versus radial forearm flap for cervical esophageal reconstruction in cancer patients: A retrospective cohort study in Colombia

Abstract Objective: This study aimed to describe clinical outcomes of anterolateral thigh (ALT) and radial forearm flap in hypopharyngeal and esophageal reconstruction in a fourth level hospital in Bogotá, Colombia. Methods: This retrospective study included 38 patients who esophageal functional reconstruction using radial forearm or ALT flap at our center between February 2010 and December 2017. Results: Mean age was 51 years. About 80% of the included patients were females. Laryngoesophageal defects were present in 80%. Total circumferential reconstruction was required in 60% of patients. Brachial-radial grafts were performed in 26% and anterolateral thigh flaps in 74%. Overall, early complication rate was 30%, which 20% were fistulae (brachial-radial, 2.8%; ALT free flap, 8.3%). Late complications (20%) included stenosis and distal graft lumen obstruction. Only 10% of patients were unable to tolerate oral feeding and 50% of this patient needed permanent gastrostomy. Regarding oncological follow-up during the 24-month post-operative, no tumor recurrence was observed. Conclusions: Functional outcomes of reconstruction with brachial-radial and ALT flap were satisfying. Our findings suggest that ALT has a lower incidence of post-operative complications than radial forearm flap. The choice of the type of flap will depend on the size and location of the defect. Small and partially covered defects benefit from the use of a radial flap, and for larger and circumferential pharyngeal reconstructions with possible radiotherapy requirements, they benefit from an ALT flap.

Bibliographic Details

Main Authors:	Moreno,Andrey, Cabrera,Luis F., Pedraza,Mauricio, Rojas,Andres, López,Paula, Sanchez,Sebastián, Gomez,María Angela, Correa,Susana
Format:	Digital revista
Language:	English
Published:	Academia Mexicana de Cirugía A.C. 2021
Online Access:	http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2021000400461
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