Document Detail


The role of pectoralis major muscle flap in salvage total laryngectomy.
MedLine Citation:
PMID:  19841342     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ziv Gil; Amar Gupta; Ben Kummer; Peter G Cordeiro; Dennis H Kraus; Jatin P Shah; Snehal G Patel
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  135     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1019-23     Citation Subset:  AIM; IM    
Affiliation:
Head and Neck Surgery Service, Department of Surgery, Memorial Sloan-KetteringCancer Center, New York, USA. ziv@baseofskull.org
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Chi-Square Distribution
Female
Graft Survival
Humans
Laryngeal Neoplasms / surgery*
Laryngectomy / methods*
Male
Middle Aged
Pectoralis Muscles / transplantation*
Postoperative Complications
Proportional Hazards Models
Retrospective Studies
Salvage Therapy
Surgical Flaps
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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