Free Flap Versus Pedicled Flap Reconstruction of Laryngopharyngeal Defects: A 10-Year National Surgical Quality Improvement Program Analysis

The Laryngoscope
Yarah M HaidarTjoson Tjoa

Abstract

Large defects after total laryngectomy (TL) and total laryngopharyngectomy (TLP) often benefit from free flap (FF) or pedicled flap (PF) reconstruction to maintain continuity of the aerodigestive tract, protect great vessels, or reinforce pharyngeal closure. Although both techniques are commonly used, no consensus exists as to which results in fewer complications. The goal of this study was to determine if 30-day morbidity/mortality outcomes differ between PF and FF reconstruction in patients undergoing TL/TLP. Retrospective cohort study. Patients were analyzed who underwent TL/TLP with reconstruction using records from the American College of Surgeons National Surgical Quality Improvement Program database (2005-2015). A total of 347 patients were included; 204 received FF reconstruction, whereas 143 received PF reconstruction. FF reconstruction was more commonly used with TLP defects (P = .001). The total operative time in the FF (590 ± 140 minutes) was longer than the PF (441 ± 125 minutes) group (P < .0001). There was a higher rate of postoperative transfusions in those undergoing FF reconstruction (P = .022). There was no significant difference in complication rates among TLP patients. Among TL patients only, FF reconstruct...Continue Reading

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Citations

Aug 17, 2020·Current Opinion in Otolaryngology & Head and Neck Surgery·Nora C ElsonBrian P Cervenka
Sep 30, 2020·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Claudia I CabreraMark S Weidenbecher
Aug 10, 2020·The Laryngoscope·Andy BertolinGino Marioni
Oct 11, 2020·The Laryngoscope·Derek EscalanteYadranko Ducic
Feb 23, 2021·Laryngoscope Investigative Otolaryngology·Daniel JacobsBenjamin L Judson

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