Use of omentum pedicled graft to protect great vessels in gastric transposition for pharyngoesophageal cancer

Background and Objectives: Transmediastinal gastric transposition and phary ngogastric anastomosis is perhaps one of the most widely accepted methods f or restoration of the alimentary continuity after pharyngoesophageal resect ion. The need of neck dissection, mediastinal tracheostomy, and previous ra diotherapy may favor exposure and rupture of major vessels. Protection with omentum may prevent this complication. A comprehensive review of omentum f lap use in surgery was undertaken. Methods: A modified omentum pedicled flap was used in 6 out of 36 patients submitted to total pharyngolaryngoesophagectomy and gastric transposition ( PLE&GT). Results: None of the patients had major vessel rupture as compared with a 1 3% carotid and innominate artery rupture of a series of 30 patients previou sly operated on without omentum pedicled flap protection. Conclusions: The omental pedicled flap, performed as described, may provide reliable protection for carotid and innominate artery exposure, adding lit tle time to the procedure. J. Surg. Oncol. 1999;70:181-184. (C) 1999 Wiley- Liss, Inc.