Endoscopic “Flapectomy” for Squamous Cell Carcinoma Arising from Anterolateral Thigh Flap of Hypopharynx

ABSTRACTWe present our experience of pedicled Anterolateral thigh flap for reconstruction of groin defects in cancer patients. Total of 17 flaps in 16 patients were performed between January 2001 to May 2003. 15 flaps were used for groin defects after node dissection for carcinoma of Penis (bilateral groin defects in one patient), 1 case of Squamous Cell Carcinoma of groin and 1 case of Soft Tissue Sarcoma of groin. All patients were male. 16 were myocutaneous variety and 1 was fasciocutaneous flap based on the septocutaneous perforator. Complications were few and all patients achieved durable long-term coverage. We found the flap to be technically easy and reliable.

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Comparison between anterolateral thigh free flap and jejunal flap for tissue reconstruction in patients underwent resection of pharyngoesophageal squamous cell carcinoma after radiotherapy failure: a retrospective study

BMC Surgery ◽

10.1186/s12893-021-01349-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Si-Lu Sun ◽

Bing Zhong ◽

Sui-zi Zhou ◽

Jun Liu ◽

Ya-Feng Liu ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Free Flap ◽

Tube Feeding ◽

Liquid Diet ◽

Postoperative Outcomes ◽

Anterolateral Thigh ◽

Tissue Reconstruction ◽

Radiotherapy Failure

Abstract Background Anterolateral thigh (ALT) free flap and jejunal flap (JF) were commonly used in tissue reconstruction for pharyngoesophageal squamous cell carcinoma (PESCC) with worsening tissue adhesion and necrosis after radiotherapy failure. However, the results of tissue reconstruction and postoperative complications of these two flaps are controversial. The purpose of this study was to compare outcomes between group ALT free flap and group JF in PESCC after radiotherapy failure. Methods Intraoperative information and postoperative outcomes of patients with PESCC after radiotherapy failure who underwent ALT and JF reconstruction from January 2005 to December 2019 were compared and analyzed. Results The defect size of ALT (Numbers, 34) and JF (Numbers, 31) was 36.19 ± 11.35 cm2 and 35.58 ± 14.32 cm2 (p = 0.884), respectively. ALT and JF showed no significant difference in operation time (p = 0.683) and blood loss (p = 0.198). For postoperative outcomes within 30 days both in recipient site and donor site including wound bleeding, wound dehiscence, wound infection, and pharyngocutaneous fistula, ALT free flap and JF showed similar results. Flap compromise (Numbers, 2 VS.3, p = 0.663), flap take backs (Numbers, 1 VS.1, p = 1.000), partial flap failures (Numbers, 4 VS.2, p = 0.674), and total flap failures (Numbers, 0 VS.0, p = 1.000) showed no difference between the two groups. In addition, no significance was found in hypoproteinemia between the two groups (Numbers, 4 VS.2, p = 0.674). ALT free flap was not statistically different from JF in the incidence of dysphagia at the postoperative 6 months (Numbers of liquid diet, 5VS.5; Numbers of partial tube feeding, 6VS.7; Numbers of total tube feeding, 3VS.1, p = 0.790) and 12 months (Numbers of liquid diet, 8VS.7; Numbers of partial tube feeding, 8VS.7; Numbers of total tube feeding, 5VS.5, p = 0.998). The cause of dysphagia not found to differ between the two groups both in postoperative 6 months (p = 0.814) and 12 months (p = 0.845). Conclusion Compared with JF, ALT free flap for PESCC patients after radiotherapy failure showed similar results in postoperative outcomes. ALT free flap may serve as a safe and feasible alternative for PESCC patients after radiotherapy failure.

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COMMANDO in Locoregional Recurrence of Oropharyngeal Carcinoma

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v5i2.11123 ◽

2020 ◽

Vol 5 (2) ◽

pp. 61

Author(s):

Abdul Azim Al-Abrar Ahmad Kailani ◽

Ahmad Kusyairi Khalid ◽

Mohd Razif Mohamad Yunus ◽

Irfan Mohamad

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Neck Dissection ◽

Squamous Cell ◽

Locoregional Recurrence ◽

Malignant Neoplasm ◽

Anterolateral Thigh Flap ◽

Surgical Approaches ◽

Oropharyngeal Carcinoma ◽

Tumour Resection

Squamous cell carcinoma is the most common malignant neoplasm of the upper aerodigestive tract, and presentation is usually at the late stages when the diagnosis is made. Recurrence after 1st therapy is common especially in the locoregional area of the tumour. For cancers affecting the oral cavity, oropharynx, and mandible, “COMMANDO” (Combined Mandibulectomy and Neck Dissection Operation) is one of the surgical approaches which constitutes of primary tumour resection, mandibulectomy and neck dissection. We describe a case of rapid locoregional recurrence following 1st surgical procedure of bilateral tonsillectomy and extended neck dissection of oropharyngeal squamous cell carcinoma in a young healthy individual without history of alcohol and tobacco abuse involving the right buccal region which after positron emission tomography was done, showed involvement of right pterygoid muscles, right-sided tongue muscle, and right mandible. The patient underwent redo salvage surgery and reconstruction with anterolateral thigh flap.

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