The role of pectoralis major muscle flap in salvage total laryngectomy Journal Article
| Authors: | Gil, Z.; Gupta, A.; Kummer, B.; Cordeiro, P. G.; Kraus, D. H.; Shah, J. P.; Patel, S. G. |
| Article Title: | The role of pectoralis major muscle flap in salvage total laryngectomy |
| Abstract: | Objective: To assess the utility of the pectoralis major muscle flap (PMMF) in patients undergoing salvage total laryngectomy. Design: Retrospective cohort analysis. Setting: Tertiary care cancer center. Patients: The study included 461 patients who underwent laryngectomy. Eighty of them underwent salvage surgery with primary pharyngeal closure. Interventions: Of the 80 patients, 69 (86%) underwent primary pharyngeal closure alone and 11 (14%) underwent a PMMF, which was used to buttress the pharyngeal suture line. Main Outcome Measure: Two hundred thirty-six variables were recorded for each patient. Complications related to pharyngeal closure were measured. Results: Sixty-four percent of the patients who underwent PMMF also underwent chemoradiation therapy as the initial definitive treatment compared with 25% in the non-PMMF group (P=.03). On multivariate analysis, chemoradiation therapy was the only independent predictor of pharyngocutaneous fistula formation (relative risk, 1.82; P=.02). Nevertheless, the pharyngocutaneous fistula rate was similar in the PMMF (27%) and the non-PMMF (24%) groups. Furthermore, similar durations of tube feeding, days to oral feeding, and hospitalization period were recorded in both groups. Conclusion: The PMMF should be used judiciously as a surgical adjunct in high-risk patients, with the goal of minimizing the risk for the development of a pharyngocutaneous fistula. ©2009 American Medical Association. All rights reserved. |
| Keywords: | adult; cancer chemotherapy; controlled study; treatment outcome; major clinical study; laryngectomy; postoperative period; salvage therapy; cancer radiotherapy; muscle flap; pectoralis major muscle; postoperative complication; hospitalization; tertiary health care; larynx cancer; pharyngocutaneous fistula; suturing method; tube feeding |
| Journal Title: | Archives of Otolaryngology - Head & Neck Surgery |
| Volume: | 135 |
| Issue: | 10 |
| ISSN: | 0886-4470 |
| Publisher: | American Medical Association |
| Date Published: | 2009-10-01 |
| Start Page: | 1019 |
| End Page: | 1023 |
| Language: | English |
| DOI: | 10.1001/archoto.2009.126 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 30 November 2010" - "CODEN: AONSE" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work