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Reconstruction of intrathoracic oesophagus using tubular lateral thigh free flap

Published online by Cambridge University Press:  08 March 2006

Marco Benazzo
Affiliation:
Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
Antonio Occhini
Affiliation:
Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
GianSilvio Fossati
Affiliation:
General Surgery "A", University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.
Giuseppe Caracciolo
Affiliation:
Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo, Pavia, Italy.

Abstract

The gastric pull-up or pharyngogastroplasty is the most widely used technique in reconstructing the digestive tract in cases of distal oesophageal tumours. This operation consists of drawing the stomach or part of it up through the chest and mediastinic region to the neck where a mucosal anastomosis with the residual pharyngeal act is made.

The most feared complication is proximal necrosis of the gastric stump with salivary fistulae usually followed by a mediastinitis. In the presence of such a complication the surgeon must tackle the challenge of reconstructing the missing part of the intrathoracic digestive tract. We describe the case of a patient in whom the missing intrathoracic oesophagus, following complete necrosis of a previously performed pharyngogastroplasty, was reconstructed using a revascularized lateral thigh free flap.

Type
Research Article
Copyright
Royal Society of Medicine Press Limited 2000

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