Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Plast Reconstr Aesthet Surg. 2010 Mar;63(3):446-50. doi: 10.1016/j.bjps.2008.12.015. Epub 2009 Feb 20.
Although the supercharge (additional microvascular anastomosis) technique is often used in pedicled transfer of parts of the gastrointestinal tract, this is rarely performed during free jejunal transfer (FJT). The differences in blood circulation and outcomes between the usual single pedicle flap and a double pedicle flap are not well known. Therefore, we evaluated the effect of an additional arterial anastomosis in FJT. The FJT was performed using one venous and two arterial anastomoses after hypopharyngeal cancer ablation. To assess the effects of an arterial supercharge, blood-gas analysis, including the venous partial pressure of oxygen (pO(2)) and partial pressure of carbon dioxide (pCO(2)), was performed on samples drawn thrice from the jejunal vein: before harvest, after the anastomosis of a paired artery and vein and after an additional arterial anastomosis. The result revealed that the venous pO(2) was elevated by the additional arterial anastomosis, compared with the two other measuring times (P=0.04). The venous pCO(2) did not show significant changes. By being given a dominant artery, a jejunal flap can develop a physiological circulatory environment and can establish nutritional pathways without adverse effects.
尽管在带蒂转移胃肠道部分时经常使用增压（额外的微血管吻合）技术，但在游离空肠转移（FJT）中很少进行。通常的单蒂皮瓣和双蒂皮瓣之间的血液循环和结果差异尚不清楚。因此，我们评估了在 FJT 中进行额外动脉吻合的效果。在咽癌消融后，采用一条静脉和两条动脉吻合进行 FJT。为了评估动脉增压的效果，在从空肠静脉抽取的三个样本中进行血气分析，包括静脉血氧分压（pO(2)）和二氧化碳分压（pCO(2)）：在收获之前，在配对的动静脉吻合后和进行额外的动脉吻合后。结果表明，与其他两个测量时间相比，通过额外的动脉吻合，静脉 pO(2)升高（P=0.04）。静脉 pCO(2)没有明显变化。通过给予优势动脉，空肠皮瓣可以建立生理循环环境，并建立营养途径，而不会产生不良影响。
