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Bare dorsal thoracic fascial flap for esophageal defects: an experimental study with dogs

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Abstract

Background

Reconstruction of esophageal defects has challenged reconstructive surgeons for a long time. Problems that affect the continuity of the orogastic tract influence the patient’s quality of life and general health. Bare free fascial flaps are used to restore soft tissue defects of the oral cavity because they provide thin, pliable tissues with a high capacity for epithelialization to preserve the local anatomy. An experimental study was planned to investigate reconstruction of anterior cervical esophageal defects using a pedicled dorsal thoracic fascial flap.

Methods

Eight hybrid dogs were used in the study. All operations were planned in three steps and performed with the animals under general anesthesia. For the two-layered reconstruction, the bare dorsal thoracic fascial flap was harvested and adapted like a patch to the defect.

Results

No partial or total flap loss was observed. On postoperative day 20 surgery, a complete epithelial lining on the same plane as the esophageal mucosa was observed over the flap tissue. A 4- to 5-mm longitudinal scar that did not form even a minimal stricture in any dog also was observed. No significant changes from postoperative day 20 to postoperative days 40 and 60 were observed.

Conclusion

Bare fascial flaps in the oral cavity heal with spontaneous epithelialization and with no need for skin and mucosal grafts. Fascial flaps are easy to harvest and do not cause any functional loss because they are nonfunctional units. Their thin constitution helps the surgeon to shape the tissue and even form tubed flaps.

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Disclosures

Kemal Ugurlu, Tamer Karsidag, Ilkay Huthut, Semra Karsidag, Kürsat Ozer, Bulent Sacak, and Arzu Akcal have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Plastic and Reconstructive Surgery Clinic, Sisli Etfal Research and Training Hospital, Gazi Berkay Cd. No: 13/9 Sisli, Istanbul, Turkey

    Kemal Ugurlu, Semra Karsidag & Arzu Akcal

  2. General Surgery Clinic, Haseki Research and Training Hospital, Istanbul, Turkey

    Tamer Karsidag

  3. John F. Kennedy Hospital, Istanbul, Turkey

    Ilkay Huthut

  4. Surgery Department, Veterinary Faculty, Istanbul University, Istanbul, Turkey

    Kursat Ozer

  5. Plastic and Reconstructive Surgery Clinic, Bagcilar Research and Training Hospital, Istanbul, Turkey

    Bulent Sacak

Authors
  1. Kemal Ugurlu
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  2. Tamer Karsidag
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  3. Ilkay Huthut
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  4. Semra Karsidag
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  5. Kursat Ozer
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  6. Bulent Sacak
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  7. Arzu Akcal
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Corresponding author

Correspondence to Semra Karsidag.

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Ugurlu, K., Karsidag, T., Huthut, I. et al. Bare dorsal thoracic fascial flap for esophageal defects: an experimental study with dogs. Surg Endosc 26, 1682–1689 (2012). https://doi.org/10.1007/s00464-011-2093-3

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  • DOI: https://doi.org/10.1007/s00464-011-2093-3

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