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July 1989

Replacement of Upper Esophagus: Results With Myocutaneous Flap and With Gastric Transposition

Author Affiliations

Brooklyn, NY

Arch Otolaryngol Head Neck Surg. 1989;115(7):777. doi:10.1001/archotol.1989.01860310015010

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At the recent meeting of the Eastern Section of The Triological Society in Toronto, Canada, Dr Robert J. Cusumano, New York, NY, presented a review of 25 cases of pharyngoesophageal replacement. Dr Cusumano and colleagues (Drs Carl E. Silver, Stanley C. Fell, and Berish Strauch) performed reconstructions in 10 patients, who had their lesions superior to the thoracic inlet, with a tubed pectoralis major myocutaneous flap. Fifteen patients with defects extending inferior to the thoracic inlet underwent reconstruction by total gastric transposition. Dr Cusumano described both operative procedures. Overall rate of complications (52% ), postoperative mortality (20% ), and satisfactory oral food intake (80%) was similar in both groups. The tubed pectoralis major myocutaneous flap is suitable for lesions confined to the hypopharynx, for lesions above the level of the hyoid bone, and for use in elderly and debilitated patients. Total gastric transposition is preferred by the authors for lesions extending below

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