Kashimura Tsutomu, Nakazawa Hiroaki, Shimoda Katsumi, Soejima Kazutaka, Kochi Mitsugu, Takayama Tadatoshi
Department of Plastic and Reconstructive Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
Department of Plastic and Reconstructive Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
Ann Thorac Surg. 2014 Dec;98(6):2211-3. doi: 10.1016/j.athoracsur.2014.01.073. Epub 2014 Dec 1.
The limited availability of reconstruction materials can often make it difficult to treat defects in the esophagus caused by necrosis of the transplanted intestinal tissue after cervicothoracic esophagus reconstruction. We were forced to perform flap reconstruction on a patient who suffered necrosis due to impeded blood flow of the transplanted intestinal tract after twice conducting cervicothoracic esophagus reconstruction with an intestinal tract flap. The procedure we performed was esophagus reconstruction using a pectoralis major myocutaneous flap that had been expanded with a tissue expander due to the small volume of tissue available to perform the reconstruction. This case suggested that esophagus reconstruction with a skin flap using a tissue expander should be considered as a possible treatment choice when performing reconstruction of the cervicothoracic esophagus, which requires stable blood flow and a large amount of tissue.
重建材料的供应有限，往往使得治疗颈胸段食管重建术后移植肠组织坏死所导致的食管缺损变得困难。在两次采用肠道瓣进行颈胸段食管重建后，一名因移植肠道血流受阻而发生坏死的患者，我们不得不对其进行皮瓣重建。由于可用于重建的组织量少，我们所实施的手术是使用经组织扩张器扩张的胸大肌肌皮瓣进行食管重建。该病例表明，在进行颈胸段食管重建时，由于需要稳定的血流和大量组织，应考虑使用组织扩张器皮瓣进行食管重建作为一种可能的治疗选择。
