Figure 4.

Sixty-six-year-old male suffering from a pharyngotracheal fistula after pharyngolaryngectomy (A). The esophagus was occluded over 7 cm due to a post-radiotherapy stenosis and the patient was fed via a percutaneous gastrostomy tube for 7 years (B); intraoperative view of the esophagus remnant. Reconstruction was performed using an ALT flow-through flap (C). The digestive tract was reconstructed using a free jejunum segment (D); intraoperative view to select the jejunum segment (E); intraoperative view after inset that was anastomosed distally to the outflow of the ALT (F); intraoperative view after wound closure; a segment of the jejunum was separated for postoperative perfusion monitoring (G); long-term result; the patient was eating and drinking normally.