PECTORALIS MAJOR MYOCUTANEOUS FLAP FOR RECONSTRUCTION OF PARTIAL CIRCUMFERENCE HYPOPHARYNGEAL DEFECTS

Reconstruction of partial defects of the Hypopharynx and Cervical esop hagus following resection for locally advanced carcinoma, by pectorali s major myocutanous flap (PMMF) was studied in 30 consecutive cases ov er a period of 5 years from 1988-1992 at the Tata Memorial Hospital. P atients with circumferential excisions were excluded for the purpose o f this study. Two patients died in the post-operative period due to ma ssive upper GI haemorrhage and cerebrovascular accident. These 2 patie nts were excluded from further analysis. Satisfactory oral intake was achieved in 26 (85%) patients. Pharyngocutanous fistula (PCF) develope d in 10 (29%) patients. Anastomotic strictures developed in 4 patients , out of 2 were benign and 2 were due to recurrence of disease. Median hospital stay in patients who developed PCF was 39 days as against 14 days in those who did not develop PCF. With a minimum follow up of tw o years 47% patients are dead of disease, 32% are lost to follow and o nly 14% are alive and free of disease. Statistical analysis using univ ariate and multivariate tests failed to reveal any significant predisp osing risk factors for PCE Patch PMMF for the reconstruction of partia l defects of the hypopharynx is a safe and reliable procedure.