Functional outcome following free ileocolic flap in total pharyngolaryngectomy

Reconstruction after radical resection for advanced laryngeal and hypopharyngeal cancer can be carried out with low mortality, acceptable morbidity, and a promising functional outcome.

To evaluate the functional outcome of reconstruction by a free vascularized ileocolic flap after concurrent chemoradiotherapy (CCRT) and surgery for advanced laryngeal and hypopharyngeal cancer.

Fifteen patients (all male, mean age 49.8 years) with squamous cell carcinoma of larynx (n=1) or hypopharynx (n=14) received a circumferential pharyngolaryngectomy and resection of the proximal esophagus followed by postoperative CCRT (60-65 Gy, cisplatin and 5-fluorouracil). A single-stage reconstruction was performed with a free vascularized ileocolic flap using a microsurgical technique.

The course of all operations was uneventful. Eight patients were alive at a follow-up of 24 months after operation, while seven patients died from local recurrence, distant metastasis, and suicide. Relief of dysphagia was achieved in 14 cases. Speech intelligibility was recorded in five patients.