使用股前外侧皮瓣和唾液转流管进行环状咽食管重建后的功能结果及供区并发症
Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube.
作者信息
Murray Dylan J, Gilbert Ralph W, Vesely Martin J J, Novak Christine B, Zaitlin-Gencher Sheryl, Clark Jonathan R, Gullane Patrick J, Neligan Peter C
机构信息
Division of Plastic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2007 Feb;29(2):147-54. doi: 10.1002/hed.20489.
BACKGROUND
This study reports our experience with fasciocutaneous reconstruction of circumferential pharyngoesophageal defects using an anterolateral thigh flap wrapped around a salivary bypass tube.
METHODS
The charts of 14 patients were reviewed. All patients who had reconstruction of a pharyngoesophageal defect using an anterolateral thigh flap with a salivary bypass tube between 2001 and 2005 were included.
RESULTS
There were 10 men and 4 women (mean age, 61 years). There were no fistulae reported, and the stricture rate was 14%. Eleven patients achieved oral diet sufficient to have the gastrostomy or jejunal tube removed. The patients who had tracheoesophageal puncture for voice developed functional speech. There were no flap losses. However, problems with salivary tube migration in the early cases have led to technique refinement.
CONCLUSIONS
The low complication rates and the excellent functional outcomes make the anterolateral thigh flap in combination with a salivary bypass tube a viable option for reconstruction of these difficult defects.
背景
本研究报告了我们使用包裹唾液转流管的股前外侧皮瓣对咽食管环形缺损进行筋膜皮瓣重建的经验。
方法
回顾了14例患者的病历。纳入了2001年至2005年间所有使用带唾液转流管的股前外侧皮瓣重建咽食管缺损的患者。
结果
男性10例，女性4例（平均年龄61岁）。未报告有瘘管形成，狭窄率为14%。11例患者经口饮食充足，足以拔除胃造口管或空肠管。行气管食管穿刺发音的患者产生了功能性语音。没有皮瓣坏死。然而，早期病例中唾液管移位的问题促使了技术改进。
结论
低并发症发生率和良好的功能结果使股前外侧皮瓣联合唾液转流管成为重建这些复杂缺损的可行选择。
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