OBJECTIVES

Treatment and rehabilitation results analysis of the results of patients after reconstruction of the laryngopharynx and esophagus with fragments of the gastrointestinal tract.

MATERIAL AND METHODS

Surgical treatment was performed in 121 patients aged 25 to 73 years with malignant tumors of the laryngo-pharyngo-esophageal localization over a period from 1993 to 2020. The patients underwent reconstruction of pharyngoesophageal defects using visceral autografts from various fragments of the gastrointestinal tract. Microsurgical reconstruction was performed using free autografts: gastroomental flap (n=48), small intestine flap (n=29), colic-omental flap (n=27), ileocolic flap (n=4), sigmoid flap (n=1). Also, reconstruction of the laryngopharynx and/or esophagus was performed using a gastric pull-up (n=6), small intestine transposition flap (n=1), and large intestine transposition flaps (n=5) on a vascular pedicle.

RESULTS

In the group of 121 patients, a smooth course of the postoperative period was observed in 47.1% of patients. The most frequent complication was the development of fistulas (23%). Total autograft necrosis was noted in 8.2% of cases. Postoperative mortality was 7.4% among all patients. Voice restoration was performed by implantation of a voice prosthesis in 24 patients, by using autogenous tissue from the ileocecal region in 4 patients. Voice rehabilitation was achieved in 79.1% and 75% of patients, respectively. 87.6% of patients returned to oral nutrition. Complete functional rehabilitation with restoration of oral nutrition and voice function was achieved in 26 patients (21.4%).

CONCLUSION

The use of visceral flaps for the reconstruction of the laryngopharynx and esophagus provides fast and high-quality medical and social rehabilitation.