{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:29:12Z","timestamp":1791394152755,"version":"4.3.3"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>No consensus exists regarding the most effective reconstruction after total laryngectomy with partial pharyngectomy (TLwPP). This study aims to compare different reconstructive techniques (pectoralis major myo\u2010cutaneous flap, PMMCF; anterolateral thigh flap, ALTF; radial forearm free flap, RFFF) after TLwPP in terms of pharyngocutaneous fistula (PCF), stenosis and feeding tube dependence (FTD) incidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Scopus, PubMed\/MEDLINE, Cochrane Library, and Google Scholar databases were searched. A single\u2010arm meta\u2010analysis was performed for PCF incidence, stenosis incidence, and FTD incidence on the entire cohort. An arm\u2010based network analysis was conducted to compare three different surgical interventions (PMMCF, ALTF, RFFF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 13 studies and 232 patients were included in the network meta\u2010analysis. The lowest PCF absolute risk was measured for the RFFF (11.7%, 95% CI: 2.8%\u201333.4%), compared to the ALTF (13.4%, 95% CI: 4.5%\u201332.1%) and the PMMC (49.0%, 95% CI: 19.2%\u201379.3%). The RFFF showed a stenosis absolute risk of 0.0% (95% CI: 0.0%\u20131.1%), while a higher stenosis incidence was measured for the ALTF (5.7%, 95% CI: 0.8%\u201325.2%) and the PMMCF (11.6%, 95% CI: 0.8%\u201355.1%). The RFFF showed the lowest absolute risk of FTD incidence (6.8%, 95% CI: 0.5%\u201328.1%) compared to the other reconstructive techniques (PMMCF: 12.4%, 95% CI: 2.4%\u201342.1%; ALTF: 17.5%, 95% CI: 6.4%\u201338.9%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The RFFF seems the best choice for reconstruction of partial pharyngeal defects after TLwPP due to the lower incidence of PCF, stenosis and FTD compared to the ALTF and the PMMCF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30977","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T13:30:25Z","timestamp":1666186225000},"page":"286-296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Complications of pectoralis major myo\u2010cutaneous flap, anterolateral thigh flap and radial forearm free flap after total laryngectomy with partial pharyngectomy: A systematic review and network meta\u2010analysis"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-7785","authenticated-orcid":false,"given":"Andrea","family":"Costantino","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-9115","authenticated-orcid":false,"given":"Bianca Maria","family":"Festa","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Otorhinolaryngology Unit IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se\u2010Heon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred M.","family":"Baik","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University Medical Center  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"},{"name":"Department of Speech Language Pathology &amp; 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