肋间肌蒂皮穿支皮瓣修复气管支气管食管瘘

Skin Perforator Flap Pedicled by Intercostal Muscle for Repair of a Tracheobronchoesophageal Fistula.

作者信息

Bertheuil Nicolas, Cusumano Caterina, Meal Cécile, Harnoy Yann, Watier Eric, Meunier Bernard

机构信息

Departments of Plastic, Reconstructive, and Aesthetic Surgery, Hospital Sud, University of Rennes 1, Rennes, France; INSERM U917, University of Rennes 1, Rennes, France.

Department of Hepatobiliary and Digestive Surgery, University of Rennes 1, Rennes, France.

出版信息

Ann Thorac Surg. 2017 Jun;103(6):e571-e573. doi: 10.1016/j.athoracsur.2016.12.054.

DOI:10.1016/j.athoracsur.2016.12.054

PMID:28528074

Abstract

A tracheobronchial fistula (TBF) is a rare complication when an operation is performed to treat esophageal carcinoma; no consensus treatment strategy has emerged. We describe a surgical interposition strategy, using a new flap, to repair a TBF that arose when esophageal squamous cell carcinoma was treated with neoadjuvant chemoradiation and minimally invasive esophagectomy (the 3-stage McKeown procedure). We performed a skin perforator flap pedicled by the intercostal muscle. It is a valuable option that may be the optimal first-line treatment, especially in the context of neoadjuvant radiation therapy. Furthermore, this strategy affords new options for intrathoracic reconstruction.

摘要

气管支气管瘘（TBF）是食管癌手术治疗中一种罕见的并发症；目前尚未形成共识性的治疗策略。我们描述了一种手术介入策略，使用一种新的皮瓣来修复在食管鳞状细胞癌接受新辅助放化疗和微创食管切除术（三阶段麦克尤恩手术）时出现的气管支气管瘘。我们采用了以肋间肌为蒂的穿支皮瓣。这是一种有价值的选择，可能是最佳的一线治疗方法，尤其是在新辅助放疗的情况下。此外，该策略为胸内重建提供了新的选择。