Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Cancer. 2010 Apr 1;116(7):1718-24. doi: 10.1002/cncr.24947.
: Pharyngoesophageal defects traditionally have been reconstructed using a jejunal or radial forearm flap. In 2002, the authors began using the anterolateral thigh flap for pharyngoesophageal reconstruction, and it has become our preferred method. The purpose of this study was to analyze the clinical and functional outcomes achieved using this technique.
: The medical records of 91 male and 23 female patients who underwent pharyngoesophageal reconstruction using an anterolateral thigh flap were retrospectively reviewed. Outcomes analyzed included length of hospital and intensive care unit stay, fistula and anastomotic stricture formation and other complications, swallowing and tracheoesophageal speech function, and survival. Most patients had primary (27%) or recurrent (42%) squamous cell carcinoma. Before reconstruction, 71% of patients had undergone surgery, radiotherapy, or both. There were 67 circumferential and 47 near-circumferential defects.
: Mean intensive care unit stay was 1.9 +/- 2.2 days, and mean hospital stay was 9.0 +/- 4.7 days. Two patients experienced total flap loss, and 1 patient had partial flap necrosis. Pharyngocutaneous fistulas and strictures occurred in 9% and 6% of patients, respectively. Ninety-one percent of patients tolerated an oral diet without the need for tube feeding. Tracheoesophageal puncture was performed for speech rehabilitation in 51 patients. Eight-one percent of patients with a secondary tracheoesophageal puncture achieved fluent speech versus 41% of patients with a primary tracheoesophageal puncture.
: This series demonstrates that excellent clinical and functional outcomes, with minimal donor site morbidity and quick recovery, are possible with pharyngoesophageal reconstruction using an anterolateral thigh flap. Cancer 2010. (c) 2010 American Cancer Society.
咽食管缺损传统上采用空肠或游离前臂皮瓣重建。2002 年，作者开始使用股前外侧皮瓣进行咽食管重建，该技术已成为我们的首选方法。本研究旨在分析该技术的临床和功能结果。
回顾性分析 91 例男性和 23 例女性患者的病历，这些患者均采用股前外侧皮瓣行咽食管重建。分析的结果包括住院和重症监护病房的住院时间、瘘管和吻合口狭窄等并发症的形成以及吞咽和气管食管语音功能、生存率。大多数患者患有原发性（27%）或复发性（42%）鳞状细胞癌。重建前，71%的患者接受了手术、放疗或两者的联合治疗。有 67 例为环形缺损，47 例为近环形缺损。
平均重症监护病房住院时间为 1.9±2.2 天，平均住院时间为 9.0±4.7 天。2 例患者出现全皮瓣坏死，1 例患者出现部分皮瓣坏死。咽皮瘘和狭窄的发生率分别为 9%和 6%。91%的患者无需管饲即可耐受口服饮食。51 例患者行气管食管穿刺术进行言语康复。81%的二次气管食管穿刺患者可获得流利的言语，而 41%的初次气管食管穿刺患者可获得流利的言语。
本系列研究表明，采用股前外侧皮瓣行咽食管重建可获得良好的临床和功能结果，且供区并发症少、恢复快。癌症 2010。（c）2010 年美国癌症协会。
