SynthesisActa otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale2026
A systematic review of surgical outcomes and postoperative complications based on free flap selection for reconstructing primary or recurrent locally advanced laryngeal-hypopharyngeal tumours.
Synthesis in Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Oral intake recovery following salvage laryngectomy with circumferential free flap reconstruction in a patient with prior pharyngogastric anastomosis and chemoradiation.Journal of surgical case reports · 2026Article
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11 authors.
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Abstract
Objective: To evaluate surgical outcomes and postoperative complications according to free flap selection in patients undergoing reconstruction after total or extended pharyngolaryngectomy for locally advanced (cT3-T4a) laryngeal-hypopharyngeal squamous cell carcinoma (SCC). Methods: A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, EMBASE, Cochrane and OVID databases were searched for studies published between 2000 and 2025. Adult patients undergoing partial or circumferential pharyngeal reconstruction with free flap reconstruction were included. Outcomes of interest were flap failure, pharyngocutaneous fistula (PCF), stricture and functional results. Odds ratios (OR) were calculated when feasible. Results: Twenty-three retrospective studies including 1,849 patients were analysed. The jejunal free flap (JFF) was the most commonly used reconstruction (78%), followed by the anterolateral thigh (ALT) flap (5%). Overall flap survival was high, with total flap necrosis occurring in 2.7% of cases. JFF reconstruction was associated with lower rates of stricture (3.8%) and PCF (3.3%) compared with ALT (9.2% and 5.5%, respectively). ALT reconstruction showed a significantly increased risk of stricture compared to JFF (OR 2.51, p = 0.0002). Conclusions: Free flap reconstruction after pharyngolaryngectomy is reliable, with high flap survival rates. The JFF remains associated with lower rates of luminal complications, particularly in circumferential defects, while the ALT flap represents a valid alternative. Flap selection should be individualised, and further prospective studies with standardised outcomes are warranted.
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