Evidence map›Paper›PMID 37707515›Full record

ArticleHNO2023

[Interdisciplinary defect reconstruction of upper aerodigestive fistulas-case series and treatment algorithm].

S Nolte, U Kneser, A K Bigdeli, M Aman, F Struebing, M Tisch, E Gazyakan

Abstract readEnglish Abstract
PubMed Publisher
In one paragraph

Article in HNO, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 73% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

S NolteKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland.
U KneserKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland.
A K BigdeliKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland.
M AmanKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland.
F StruebingKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland.
M TischKlinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
E GazyakanKlinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Klinik für Hand und Plastische Chirurgie der Universität Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen am Rhein, Deutschland. emre.gazyakan@bgu-ludwigshafen.de.
Berufsgenossenschaftliche Unfallklinik Ludwigshafen · DEHeidelberg University · DEBundeswehrkrankenhaus · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPersistent complex defects and dysfunctions of the upper aerodigestive tract after tumor surgery represent a major challenge. The aim of this study was to evaluate the effectiveness of an interdisciplinary approach using the free anterolateral thigh flap (ALT) as a reconstruction option in the upper aerodigestive tract. MATERIALS AND

methodsThe retrospective study identified 5 patients with complex defects after laryngectomy/pharyngolaryngectomy (LE/PLE) and multiple revision surgeries between 2017 and 2023. The operations were performed by an interdisciplinary team from otolaryngology, plastic surgery, and visceral/thoracic surgery. The results of the microsurgical reconstruction were analyzed.

resultsThere was an average of six previous operations. The defects included tracheoesophageal fistulas, pharyngocutaneous fistulas, neopharyngeal stenosis, and combinations thereof. Successful reconstruction was achieved in 100% of patients using the ALT flap. In 2 patients, ALT flow-through flaps were used with an additional free jejunal interposition (JI) and in 3 patients split-ALT flaps were used. The major complication rate was 40% and the minor complication rate was 20%.

conclusionComplex defects of the upper aerodigestive tract with multiple previous operations can be successfully reconstructed. Because of its versatility, the ALT flap seems to be a very good option. Prerequisite for this is an interdisciplinary treatment approach with a critical assessment of patient- and disease-specific factors.

Indexed as

Cutaneous FistulaFree Tissue FlapsPlastic Surgery ProceduresAlgorithmsHumansRetrospective StudiesALT flapFree jejunumHead and neck reconstructionPharyngocutaneous fistulaTracheoesophageal fistula

Identifiers

PMID37707515
OpenAlexW4386725531

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.