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<p>Reconstruction of pharyngeal defects following total laryngopharyngectomy poses significant surgical challenges, particularly in settings with limited microsurgical capabilities. The supraclavicular artery island flap (SCAIF) has become recognized as a reliable and technically simpler reconstructive approach. This retrospective study included 27 patients (median age: 59 years, range: 39–77) who underwent SCAIF reconstruction for stage III–IVa hypopharyngeal squamous cell carcinoma at a Vietnamese tertiary center between June 2022 and March 2025. Following tumor resection and confirmation of negative margins, flap dimensions were planned based on the measured defect length and anatomical reach, with an additional 1.0&#xa0;cm included to minimize inset tension. The mean pharyngeal defect length was 8.4 (7.0–11.0) cm. The mean flap length, skin paddle length, and width were 17.0 (15.0–20.0) cm, 8.7 (7.0–12.0) cm, and 7.3 (6.0–8.0) cm, respectively. Tubularized flap reconstruction was performed in two cases. The flap harvest required 38 (20–60) minutes, while total operative time averaged 193 (150–240) minutes. Pharyngocutaneous fistulas occurred in five patients (17.9%) and were managed conservatively. After adopting a two-layer closure technique with slowly absorbable polydioxanone sutures, no further fistulas were observed. In all cases, donor sites were successfully closed primarily, eliminating the need for skin graft application. The average postoperative hospital stay was 15 (11–21) days. No perioperative mortality was recorded. These findings support the SCAIF as a safe, practical, and effective alternative to free flaps for circumferential or near-total pharyngeal reconstruction. Further prospective studies are recommended to assess long-term functional outcomes and quality of life.</p>

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Surgical Experience in Applying the Supraclavicular Artery Island Flap for Reconstruction of Pharyngeal Defects After Total Laryngopharyngectomy in Vietnam

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月11日

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  • Quang Trung Nguyen,
  • Van Huu Pham,
  • Xuan Khoa Ngo,
  • Duy Thinh Ngo,
  • Minh Khang Do,
  • Van Hung Nguyen

摘要

Reconstruction of pharyngeal defects following total laryngopharyngectomy poses significant surgical challenges, particularly in settings with limited microsurgical capabilities. The supraclavicular artery island flap (SCAIF) has become recognized as a reliable and technically simpler reconstructive approach. This retrospective study included 27 patients (median age: 59 years, range: 39–77) who underwent SCAIF reconstruction for stage III–IVa hypopharyngeal squamous cell carcinoma at a Vietnamese tertiary center between June 2022 and March 2025. Following tumor resection and confirmation of negative margins, flap dimensions were planned based on the measured defect length and anatomical reach, with an additional 1.0 cm included to minimize inset tension. The mean pharyngeal defect length was 8.4 (7.0–11.0) cm. The mean flap length, skin paddle length, and width were 17.0 (15.0–20.0) cm, 8.7 (7.0–12.0) cm, and 7.3 (6.0–8.0) cm, respectively. Tubularized flap reconstruction was performed in two cases. The flap harvest required 38 (20–60) minutes, while total operative time averaged 193 (150–240) minutes. Pharyngocutaneous fistulas occurred in five patients (17.9%) and were managed conservatively. After adopting a two-layer closure technique with slowly absorbable polydioxanone sutures, no further fistulas were observed. In all cases, donor sites were successfully closed primarily, eliminating the need for skin graft application. The average postoperative hospital stay was 15 (11–21) days. No perioperative mortality was recorded. These findings support the SCAIF as a safe, practical, and effective alternative to free flaps for circumferential or near-total pharyngeal reconstruction. Further prospective studies are recommended to assess long-term functional outcomes and quality of life.