BACKGROUND: Stomal recurrence in patients after laryngectomy has a poor prognosis. Studies performed using sternal resection with pectoralis flap reconstruction report <25% 2-year survival. The purpose of this study was to ascertain whether the use of larger resection with free flap reconstruction improves survival. METHODS: Thirteen cases of stomal recurrence that underwent extended sternal resection and free flap reconstruction were identified and classified according to Sisson criteria. Postoperative morbidity, mortality, and survival were assessed. RESULTS: Median survival was 10 months in patients with Sisson types I and II, with 37.5% 1-year and 25% 2-year survival. Median survival was 6 months in patients with Sisson types III and IV, with 40% 1-year and 0% 2-year survival. There were 2 perioperative deaths and a major morbidity rate of 45%. CONCLUSION: Salvage surgery using free flap reconstruction did not show improved survival rates compared with previously described techniques.
BACKGROUND: Stomal recurrence in patients after laryngectomy has a poor prognosis. Studies performed using sternal resection with pectoralis flap reconstruction report <25% 2-year survival. The purpose of this study was to ascertain whether the use of larger resection with free flap reconstruction improves survival. METHODS: Thirteen cases of stomal recurrence that underwent extended sternal resection and free flap reconstruction were identified and classified according to Sisson criteria. Postoperative morbidity, mortality, and survival were assessed. RESULTS: Median survival was 10 months in patients with Sisson types I and II, with 37.5% 1-year and 25% 2-year survival. Median survival was 6 months in patients with Sisson types III and IV, with 40% 1-year and 0% 2-year survival. There were 2 perioperative deaths and a major morbidity rate of 45%. CONCLUSION: Salvage surgery using free flap reconstruction did not show improved survival rates compared with previously described techniques.
Authors: Carlos Hernández-Brito; María Alejandra Salazar-Álvarez; Mario Enrique Álvarez-Bojórquez; Francisco Carlos Cisneros-Juvera; Javier López-Gómez; Ángel Elizalde-Méndez; Martín Granados-García Journal: Int J Surg Case Rep Date: 2018-08-09