SỰ PHÙ HỢP CỦA VẠT DA CÂN THƯỢNG ĐÒN TRONG TẠO HÌNH KHUYẾT THIẾU ỐNG HỌNG SAU PHẪU THUẬT CẮT HẠ HỌNG THANH QUẢN TOÀN PHẦN

Abstract

Objective: To evaluate the anatomical characteristics of the supraclavicular artery island flap (SCAIF) and its suitability for pharyngeal reconstruction after total laryngopharyngectomy. Methods: Cross-sectional descriptive study with two parts: (1) dissection of 15 fresh-frozen cadavers (30 flaps) to assess the origin, diameter, and length of the supraclavicular artery and the perfusion territory; (2) a clinical series of 30 patients with advanced hypopharyngeal cancer who underwent total laryngopharyngectomy, bilateral neck dissection, and pharyngeal reconstruction using SCAIF. Collected variables included T and N stage, defect size, flap dimensions, operative times, complications, and length of hospital stay; data were analyzed descriptively. Results: In 15 cadavers (30 flaps), the mean perfusion territory was 17.3 × 9.2 cm; the supraclavicular artery arose from the transverse cervical artery in 100% of cases, with a diameter of 3.1 (2.9–3.4) mm and a length of 4.3 (3.7–5.3) cm. In 30 operated patients, defect length was 8.7 (7–11) cm; harvested flap length was 18.4 (16–20) cm, with a mean skin paddle of 8.7 × 7.3 cm for reconstruction. Flap harvest time was 29.5 (20–40) minutes; mean total operative time was 184 minutes. No pharyngocutaneous fistula, surgical site infection, or mortality was observed. Mean hospital stay was 13 days. Conclusion: SCAIF demonstrates stable vascular anatomy, is straightforward to harvest, shortens operative time, and is associated with low complication rates. It is a suitable option for pharyngeal reconstruction after total laryngopharyngectomy, particularly in settings with limited microsurgical resources.