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September 1983


Arch Otolaryngol. 1983;109(9):634. doi:10.1001/archotol.1983.00800230070018

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To the Editor.—The valuable article published in the November Archives (1982;108:685-687) by Freeman et al entitled "Greater Omentum Used for Carotid Cover After Pharyngolaryngoesophagectomy and Gastric 'pullup' or Colonic 'Swing' " would seem to support my contention that the stomach is the organ of choice. Omentum is invariably present in the neck at completion of this operation and may even have to be removed because of excess bulk. In a personal series of 90 pull-up operations, adequate omentum was found to be attached to the stomach when it entered the neck in 81 cases. In the patients requiring neck dissection it was readily available for coverage of the carotid artery, and this technique has been standard procedure since our first operation in 1965. There is rarely need, therefore, for the development of the ingenious, subcutaneous pedicled omentum described in this article when mobilizing the stomach. I have had no instance

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