Tubed pectoralis major musculocutaneous flaps for cervical esophageal replacement

Five patients undergoing laryngopharyngectomy and cervical esophagectomy for cancer were reconstructed using a tubed pectoralis major musculocutaneous flap for esophageal replacement. One patient had no complications, 2 had pinpoint fistulas with rapid healing, a fourth died of a myocardial infarction, and the fifth had a partial breakdown requiring secondary flap closure. This flap is safe, reliable, and easy to rotate and tube on itself; use of the tubed pectoralis major musculocutaneous flap obviates the necessity for laparotomy for colon interposition, gastric pull-through, or jejunal free grafts. In addition, microvascular anastomoses are not required. Therefore, it is recommended as an excellent means of replacing the cervical esophagus and should be considered a method of choice in debilitated patients.