Simultaneous tracheal and esophageal reconstruction for thyroid cancer involving trachea and esophagus using a free bipaddled posterior tibial artery perforator flap

Head Neck. 2019 Sep;41(9):3472-3477. doi: 10.1002/hed.25850. Epub 2019 Jun 25.

Abstract

Background: Simultaneous tracheal and esophageal reconstruction after tumor resection is a great challenge. Here we present an innovative operative technique to simultaneously reconstruct tracheal and esophageal defects, in which a free posterior tibial artery perforator flap was made into a free bipaddled flap to cover both tracheal and esophageal defects.

Methods: A free bipaddled posterior tibial artery perforator flap was utilized to conduct simultaneous tracheal and esophageal reconstruction for a 72-year-old female patient with papillary thyroid carcinoma and massive trachea and esophagus invasion, who underwent radical resection.

Results: Satisfactory breathing and swallowing functions were gained independent of nasal feeding and tracheotomy. Voice was still hoarse due to tumor invasion of left recurrent laryngeal nerve. During a period of 2-year follow-up, no sign of tumor recurrence was observed.

Conclusion: A free bipaddled posterior tibial artery perforator flap could be a decent choice for simultaneous reconstruction of large tracheal and esophageal defects.

Keywords: esophageal reconstruction; free bipaddled posterior tibial artery perforator flap; simultaneous reconstruction; thyroid cancer; tracheal reconstruction.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Esophagus / surgery
  • Female
  • Free Tissue Flaps*
  • Humans
  • Perforator Flap*
  • Plastic Surgery Procedures / methods*
  • Thyroid Cancer, Papillary / pathology
  • Thyroid Cancer, Papillary / surgery*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Trachea / surgery