利用胸锁乳突肌瓣修复晚期喉癌患者医源性气管食管瘘：1例报告及文献复习
Using a Sternocleidomastoid Muscle Flap to Close an Iatrogenic Tracheoesophageal Fistula in a Patient With Advanced Laryngeal Cancer: A Case Report and Literature Review.
作者信息
Chuang Fu-Chieh, Tung Kwang-Yi, Huang Wen-Chen, Yu Chia-Meng, Yao Wen-Teng
机构信息
From the Department of Plastic Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
出版信息
Ann Plast Surg. 2019 Jan;82(1S Suppl 1):S126-S129. doi: 10.1097/SAP.0000000000001718.
BACKGROUND
An iatrogenic tracheoesophageal (TE) fistula is one possible complication after total laryngectomy with flap reconstruction. We used sternocleidomastoid (SCM) rotation flap to close a TE fistula.
METHODS AND RESULTS
A 69-year-old man with laryngeal cancer underwent total laryngectomy with radial forearm free flap reconstruction. A tracheostoma stenosis was noticed 7 months after the tracheostomy tube was removed. The patient underwent tracheostoma dilatation; the iatrogenic TE fistula was noticed 1 month later. We used SCM rotation flap to close the TE fistula. The postoperative course was uneventful. A barium esophagogram showed no leakage in the esophagus.
CONCLUSIONS
Tracheoesophageal fistula can be reconstructed with an SCM rotation flap. If the TE fistula is of a suitable size, this reconstructive strategy is effective and simple to close persistent TE fistula and avoid further airway complications.
背景
医源性气管食管瘘是全喉切除并皮瓣重建术后可能出现的一种并发症。我们采用胸锁乳突肌（SCM）旋转皮瓣来闭合气管食管瘘。
方法与结果
一名69岁的喉癌男性患者接受了全喉切除及桡侧前臂游离皮瓣重建术。气管切开管拔除7个月后发现气管造口狭窄。患者接受了气管造口扩张术；1个月后发现医源性气管食管瘘。我们采用胸锁乳突肌旋转皮瓣来闭合气管食管瘘。术后过程顺利。食管钡餐造影显示食管无渗漏。
结论
气管食管瘘可用胸锁乳突肌旋转皮瓣进行重建。如果气管食管瘘大小合适，这种重建策略对于闭合持续性气管食管瘘并避免进一步的气道并发症是有效且简单的。
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