Instructional Session: ISW3

Wednesday 4 July 2018, 16.45-17.45

Reconstruction of hypopharynx and cervical esophagus defects

Cesare Piazza, Fondazione IRCCS, National Cancer Institute of Milan; University of Milan

Hypopharyngeal and cervical esophageal cancers resection frequently require subtotal or circumferential digestive tract resections. Its proper reconstruction is essential for cancer cure and patient’s survival/quality of life. I herein present different reconstructive options ranging from pedicled (pectoralis major and gastric pull up) to microvascular flaps (fascio-cutaneous like radial and antero-lateral thigh or visceral like jejunum), underlining specific pros and cons of each of them. I then present my own experience based on 211 such procedures, with specific referral to the outcomes obtained by fascio-cutaneous free flaps. Pearls and pitfalls related to their harvesting and 3D arrangement in case of partial and total hypopharyngeal-cervical esophageal resections will be underlined. Specific clinical cases of either primary and salvage resections as well as of primary or secondary reconstructions after previous failure will be discussed. Videos and detailed photos will enhance tips and tricks from a quite practical point of view.