Plastic Surgery Department, China Medical University and China Medical University Hospital, 2, Yuh-Der Road, Taichung, Taiwan.
J Plast Reconstr Aesthet Surg. 2012 Jun;65(6):752-6. doi: 10.1016/j.bjps.2011.12.025. Epub 2012 Feb 24.
In simultaneous reconstructions of cervical oesophagus and voice mechanism with free ileocolon flap, one of the most cumbersome complications is the anastomotic leakage at the junction between the colon and thoracic oesophagus.
Since 2007, a chimaeric sero-muscular flap has been islanded from the distal end of the voice tube to cover the anterior aspect of the colo-oesophageal junction. Fourteen patients undergoing reconstruction of the hypopharyngo-laryngectomy defects were consecutively treated with the sero-muscular flap. The leakage rate was compared with a group of 15 patients who were reconstructed with a free ileocolon flap prior to the adoption of the new procedure.
All flaps survived completely. Swallowing function (scores 5-7), was restored in 69% of the patients. Speech function was restored (scores 4-5) in 59% of the patients. In the treatment group, only one patient suffered from anastomotic leakage compared to four patients in the control group.
The chimaeric sero-muscular flap can secure the colo-oesophageal junction, improving the healing process and preventing delays in the administration of adjuvant therapy.
在游离空肠结肠瓣同期重建颈段食管和发音器官时，最棘手的并发症之一是结肠与胸段食管交界处吻合口漏。
自 2007 年以来，我们从声管的远端游离出一个复合黏膜-肌瓣来覆盖结肠-食管吻合口的前壁。14 例下咽-喉切除术缺损患者连续接受了黏膜-肌瓣重建。将吻合口漏的发生率与采用新方法前的 15 例接受游离空肠结肠瓣重建的患者进行比较。
所有的皮瓣均完全存活。69%的患者吞咽功能（评分为 5-7 分）恢复。59%的患者恢复了语言功能（评分为 4-5 分）。在治疗组中，只有 1 例患者发生吻合口漏，而对照组有 4 例患者发生吻合口漏。
复合黏膜-肌瓣可以固定结肠-食管吻合口，改善愈合过程，防止辅助治疗的延迟。
