Retrospective analysis compares dietary outcomes and fistula rates in hypopharyngeal reconstruction using ileocolonic and ALT flaps, suggesting substantial differences.
Objectives This study compares the outcomes of free ileocolonic and tube‐shaped anterolateral thigh (ALT) fasciocutaneous flaps in reconstructing total hypopharyngeal defects. Methods A retrospective analysis was conducted on 76 patients who underwent reconstruction with either an ileocolonic flap ( n = 20) or a tube‐shaped ALT flap ( n = 56) between 2011 and 2021. Primary outcomes included dietary tolerance at 1 and 3 years, pharyngocutaneous fistula rates, and survival. Statistical analyses assessed group differences in complications and dietary restrictions. Results The ileocolonic flap group demonstrated superior dietary outcomes at 1 and 3 years (90% vs. 62.5% and 90% vs. 51.4%, respectively) but had a higher fistula rate (25% vs. 7.1%, p = 0.048). No significant differences in survival were observed between the groups. Conclusion The ileocolonic flap offers better long‐term dietary outcomes despite higher early fistula rates. Further research is recommended to optimize flap selection for hypopharyngeal reconstruction.
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Chen et al. (2025) studied this question.
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