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Ann Thorac Surg 2006;81:1090-1094
© 2006 The Society of Thoracic Surgeons

Original article: General thoracic

Platysma Myocutaneous Flap for Patch Stricturoplasty in Relieving Short and Benign Cervical Esophageal Stricture

Yi-Dan Lin, MD, Yao-Guang Jiang, MD * , Ru-Wen Wang, MD, Tai-Qian Gong, MD, Jing-Hai Zhou, MD

Thoracic Surgery Department, Daping Hospital, Third Military Medical University, Chongqing City, China

Accepted for publication September 1, 2005.

* Address correspondence to Dr Jiang, Thoracic Surgery Department, Daping Hospital, Third Military Medical University, Changjiang Branch St, 10, Yuzhong District, Chongqing City, 400042 PR China (Email: stilldaniel{at}yahoo.com.cn).

BACKGROUND: The purpose of this study is to introduce the use of a single-staged and laterally based platysma myocutaneous flap in patch stricturoplasty for relieving short and benign cervical esophageal stricture.

METHODS: Medical records were reviewed for 28 patients undergoing platysma myocutaneous flap for patch stricturoplasty in covering and widening short and benign cervical esophageal stricture in our department during the period between April 1990 and January 2004. The length of follow-up ranged from 4 months to 10 years with an average of 5 years. The surgical technique was described and the follow-up data was analyzed.

RESULTS: There were no operation deaths and all flaps survived without any necrosis. Anastomosis leakage developed in three cases (ie, two that were small and healed spontaneously after cervical drainage, whereas the third needed surgical revision). Re-stenosis occurred between the transposed flap and the gullet in two cases, one of which was relieved by repeated esophageal dilations and the other one was resolved by reoperation. No ulceration or carcinogenesis was discovered in the skin paddle during the time of follow-up. Pathologic analysis showed that the keratin layer of the skin paddle became thinner but was still arranged in the same structure as that of the normal skin. At the end of the follow-up, all 28 patients gained body weight on a regular oral diet.

CONCLUSIONS: Platysma myocutaneous flap can be accomplished in a single stage owning many advantages in comparison with other flaps for patch stricturoplasty in relieving the short and benign cervical esophageal stricture (ie, it is closer to the recipient site, thinner, pliable, and reliable).






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