Local Random Flaps For Cervical Circumferential Defect Or Tracheoesophageal Fistula Reconstruction After Failed Gastric Pull-Up: Two Case Reports

Abstract

Background Total Pharyngo-Laryngo-Esophagectomy With A Reconstruction Of Gastric Pull-Up Is The Most Common Treatment Method For Patients With Multiple Primary Upper Digestive Tract Carcinomas, Such As Hypopharyngeal Carcinoma With Thoracic Esophageal Carcinoma. However, Neck Circumferential Defect And Tracheoeso-Phageal Fistula After Gastric Necrosis Are Still Challenging Problems For Surgeons And Patients. Case Summary This Case Report Presents 2 Patients Who Underwent Reconstructive Surgeries Using 4 Local Random Flaps With A Split Thickness Skin Graft In The First Case, And 6 Local Random Flaps In The Second Case To Close The Circumferential Defect And Tracheoesophageal Fistula After Failed Gastric Pull-Up. Both Patients Achieved Good Swallowing Function And Could Take Solid Diet Without Dysphagia Postoperatively. Conclusion For Selected Patients, Local Random Flaps (With A Split Thickness Skin Graft) Can Be A Simple And Reliable Solution For Reconstructing Tracheoesophageal Fistula Or Cervical Circumferential Defect After Gastric Necrosis, Especially When The Necrosis Extends Below The Thoracic Inlet.