A turnover de-epithelialised deltopectoral flap to close fistulae following antethoracic oesophageal reconstruction

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WITH modern surgical and anaesthetic techniques the mortality after oesophageal resection and reconstruction for cancer is now less than IO per cent. despite the fact that surgery is now offered to many elderly or poor-risk patients. For these patients antethoracic oesophageal reconstruction is the method of choice but the incidence of suture breakdown and subsequent fistula formation is higher than with other reconstructive procedures because of inadequate blood supply, malnutrition and high intraluminal pressure. These fistulae, once established, rarely heal spontaneously. This paper describes a method of closing such fistulae, with a turnover deepithelialised deltopectoral flap. TECHNIQUE

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