J Reconstr Microsurg 2006; 22 - A044
DOI: 10.1055/s-2006-958692

Plication of the Ileocolic Valve to Prevent Food Reflux when an Ileocolon Flap is Used for Reconstruction of Esophagus and Voice

Hung-Chi Chen 1, 2, Yueh-bih Tang 1, 2, Samir Mardini 1, 2
  • 1National Taiwan University, Kaohsiung, Taiwan
  • 2E-Da Hospital, Kaohsiung, Taiwan

The advancement of microvascular bowel transfer has brought about good results in esophageal reconstruction. Within the last 10 years, the ileocolic flap has been advocated for simultaneous reconstruction of the esophagus and voice tube after total pharyngolaryngectomy. However, food reflux should be prevented to avoid aspiration.

From January 2003 to December 2004, internal plication of the ileocecal valve has been performed in 28 patients during transfer of the ileocolic flap. Using nonabsorbable sutures, a final orifice of 4 mm has been achieved. The postoperative follow-up included the incidence of reflux and aspiration pneumonia, voice quality, and other complications.

Partial loss of the anterior wall was found in one patient and was treated with a left DP flap. One patient required revision of the ileocecal junction. There was no patient who sustained aspiration pneumonia.

This method is effective to minimize the chance of aspiration, and is recommended when an ileocecal flap is used for simultaneous reconstruction of pharyngoesophagus and voice tube.