Closure of Tracheoesophageal Fistula Employing the Superficial Circumflex Iliac Artery Perforator ( SCIP ) Flap: Report of Three Cases

ABSTRACT

The tracheoesophageal fistula (TOF) is defined as a pathological connection between the trachea and esophagus, both congenital and acquired. The latter is often associated with malignancies or their treatments. Reconstruction in this context is particularly challenging due to the defect's location, size, and compromised tissue quality. Here, we present for the first time the surgical treatment of TOF using a free superficial circumflex iliac artery perforator (SCIP) flap. Three patients were included in the present report (84‐year‐old female, 74‐year‐old male, 62‐year‐old male). Two patients developed a TOF following total laryngectomy combined with partial pharyngectomy, and one patient, following total laryngectomy without partial pharyngectomy. All the patients received a surgical treatment for a head and neck malignancy. The TOFs were successfully closed in three patients using a SCIP‐Flap. The elevated SCIP‐Flap measured on average 15 × 8 cm. In two cases, the return to a normal, oral diet was established within 1–3 months with successful vocal rehabilitation. The third case did not return to a complete oral diet because of a dehiscence and ongoing palliative chemotherapy. The other two patient underwent 1‐year follow‐up without complications. This report suggests that the SCIP flap could be a feasible low morbidity and relatively straightforward reconstructive option, yielding favorable postoperative outcomes for TOF even in cases of multiple prior surgeries and adjuvant radiochemotherapy treatment.