Sundaram Krishnamurthi, Har-El Gady
Department of Otolaryngology, State University of New York-Health Science Center, Brooklyn, New York, and The Long Island College Hospital, Brooklyn, New York, USA.
Head Neck. 2002 Apr;24(4):395-400. doi: 10.1002/hed.10035.
Complete circumferential pharyngoesophageal reconstruction has undergone remarkable changes and developments during the last three decades. Gastric transposition and microvascular techniques are the standards of care. However, in cases of failure, or where other factors such as severe comorbidities prevent the use of microvascular techniques, reconstruction with local flaps provide a reliable option. We have used the Wookey flap technique in six patients with complete circumferential loss of the pharynx and upper esophagus. To make the procedure more reliable, we added a "delay" stage.
Retrospective review of charts of six Wookey-type reconstructions of the pharynx and upper esophagus done in our department at SUNY-HSC, Brooklyn, and The Long Island College Hospital.
Five of the six patients had successful reconstruction of complete circumferential pharyngoesophageal resection. All five resumed oral alimentation. The flap failed in one patient.
The Wookey flap may still provide surgeons with a "last resort" reconstructive option after complete, circumferential pharyngoesophageal resection.
在过去三十年中，全周性咽食管重建术经历了显著的变化和发展。胃移位术和微血管技术是标准的治疗方法。然而，在手术失败的情况下，或者在存在严重合并症等其他因素妨碍使用微血管技术时，采用局部皮瓣进行重建提供了一种可靠的选择。我们对6例咽和上段食管全周性缺损的患者采用了伍基皮瓣技术。为使手术更可靠，我们增加了一个“延迟”阶段。
回顾性分析在纽约州立大学卫生科学中心布鲁克林分校以及长岛学院医院我们科室进行的6例伍基式咽和上段食管重建手术的病历。
6例患者中有5例成功完成了全周性咽食管切除术的重建。所有5例患者均恢复经口进食。1例患者皮瓣失败。
在全周性咽食管切除术后，伍基皮瓣可能仍为外科医生提供一种“最后的”重建选择。
