| The role of pectoralis major muscle flap in salvage total laryngectomy. | |
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MedLine Citation:
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PMID: 19841342 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ziv Gil; Amar Gupta; Ben Kummer; Peter G Cordeiro; Dennis H Kraus; Jatin P Shah; Snehal G Patel |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2009-10-20 Completed Date: 2009-12-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8603209 Medline TA: Arch Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1019-23 Citation Subset: AIM; IM |
Affiliation:
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Head and Neck Surgery Service, Department of Surgery, Memorial Sloan-KetteringCancer Center, New York, USA. ziv@baseofskull.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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