口咽、下咽及颈段食管重建：带蒂皮瓣的应用经验

Oropharyngeal, Hypopharyngeal and Cervical Esophageal Reconstruction: An Experience of Pedicle Flaps.

作者信息

Khalid Farrukh Aslam, Saleem Muhammad, Yousaf Muhammad Amin, Mujahid Abdul Malik, Shahzad Imran, Tarar Moazzam Nazeer

机构信息

Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center / Allama Iqbal Medical College, Lahore, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2019 Feb;29(2):168-172. doi: 10.29271/jcpsp.2019.02.168.

DOI:10.29271/jcpsp.2019.02.168

PMID:30700358

Abstract

OBJECTIVE

To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre.

STUDY DESIGN

Retrospective study.

PLACE AND DURATION OF STUDY

Jinnah Burn and Reconstructive Surgery Centre, Lahore, from June 2007 to June 2017.

METHODOLOGY

All patients who underwent oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicled flaps were included.

RESULTS

Thirty-two reconstructions were done, of which 16 (50.0%) were supraclavicular flaps, 12 (37.5%) were pectoralis major myocutaneous flaps (PMMF) and 4 (12.5%) platysma myocutaneous flaps (PMF). Among these, 24 (75%) were males and 8 (25%) females. The mean hospital stay was 18.75 +5.45 days. Complications were noted in 12 (37.5%), salivary fistula being the most frequent found in 6 (18.75%). Wound dehiscence was noted in 4 (12.5%), partial flap necrosis and wound infection present in 1 (3.1%) each.

CONCLUSION

Oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicle flaps is still very useful and safe to perform, associated with minimal flap and donor site complications.

摘要

目的

回顾三级医疗中心采用带蒂皮瓣修复下咽切除术后咽颈段食管缺损的一期重建经验。

研究设计

回顾性研究。

研究地点和时间

2007年6月至2017年6月，拉合尔真纳烧伤与重建外科中心。

方法

纳入所有采用带蒂皮瓣进行口咽、下咽和颈段食管重建的患者。

结果

共进行了32例重建手术，其中16例（50.0%）采用锁骨上皮瓣，12例（37.5%）采用胸大肌肌皮瓣（PMMF），4例（12.5%）采用颈阔肌肌皮瓣（PMF）。其中，男性24例（75%），女性8例（25%）。平均住院时间为18.75±5.45天。12例（37.5%）出现并发症，最常见的是唾液瘘，有6例（18.75%）。4例（12.5%）出现伤口裂开，1例（3.1%）出现部分皮瓣坏死，1例（3.1%）出现伤口感染。