Closure of esophageal defects with muscle flaps.

OBJECTIVE

To determine the feasibility and reliability of muscle flaps as a sole means of closure of severe esophageal defects.

DESIGN

Retrospective case series of patients with esophageal defects closed with muscle flaps. Mean follow-up was 6 years.

SETTING

A university hospital and a tertiary care, university-affiliated, private hospital.

PATIENTS: Fourteen patients with esophageal defects that could not be closed by standard suture techniques or failed to close with observation alone.

MAIN OUTCOME MEASURES: Survival, continued esophageal leakage, restoration of esophageal continuity, and long-term esophageal function.

RESULTS

There was one operative death and one delayed death, both unrelated to the esophageal injury. There were five early leaks that healed promptly. Esophageal continuity was restored in all patients. Long-term esophageal function has been excellent.

CONCLUSIONS

The use of primary muscle repair for esophageal defects not amenable to standard closure techniques provides an excellent means of closing esophageal wounds and restoring esophageal continuity. This option appears to be preferable to other more destructive options in managing this serious problem.