COMPARATIVE-EVALUATION IN PHARYNGOESOPHAGEAL RECONSTRUCTION - RADIAL FOREARM FLAP COMPARED WITH JEJUNAL FLAP - A 10-YEAR EXPERIENCE

We reviewed 109 consecutive patients with cancer of the hypopharynx or cervical oesophagus who underwent free flap transfer for immediate re construction after total pharyngolaryngo-oesophagectomy. The free flap s used were either free jejunal (n = 70) or radial forearm flaps (II = 39). Significantly more fistulas (3/70 compared with 15/39, p < 0.000 1) and strictures (6/64 compared with 13/33, p = 0.0008) developed in the radial forearm than the jejunal flap group. However, functional do nor site morbidity was minimal and there were no cases of total flap n ecrosis in the forearm flap group. We consider that the free jejunal f lap should be the first choice for total reconstruction of pharyngo-oe sophageal defects. However, the forearm flap is suitable for elderly, high risk patients, because it is less invasive and has minimal donor site morbidity, which facilitates early recovery.