The use of a chimaeric sero-muscular flap to prevent anastomotic leakage in head and neck reconstruction with free ileocolon flap

Background: In simultaneous reconstructions of cervical oesophagus and voice mechanism with free ileocolon flap, one of the most cumbersome complications is the anastomotic leakage at the junction between the colon and thoracic oesophagus. Methods: Since 2007, a chimaeric sero-muscular flap has been islanded from the distal end of the voice tube to cover the anterior aspect of the colo-oesophageal junction. Fourteen patients undergoing reconstruction of the hypopharyngo-laryngectomy defects were consecutively treated with the sero-muscular flap. The leakage rate was compared with a group of 15 patients who were reconstructed with a free ileocolon flap prior to the adoption of the new procedure. Results: All flaps survived completely. Swallowing function (scores 5-7), was restored in 69% of the patients. Speech function was restored (scores 4-5) in 59% of the patients. In the treatment group, only one patient suffered from anastomotic leakage compared to four patients in the control group. Conclusions: The chimaeric sero-muscular flap can secure the colo-oesophageal junction, improving the healing process and preventing delays in the administration of adjuvant therapy.