Department of Reconstructive Microsurgery, China Medical University Hospital, Taiwan and Department of Plastic and Reconstructive Surgery, University of the Witwatersrand, South Africa.
Department of Plastic and Reconstructive Surgery, University of the Witwatersrand, South Africa.
S Afr J Surg. 2020 Mar;58(1):43.
Tracheostomal stenosis is a distressing complication with a high incidence rate post laryngectomy. We aimed to assess the deltopectoral flap (DPF) for tracheostomal stenosis correction in irradiated patients.
Six patients with tracheostomal stenosis, 3 of whom developed restenosis after prior use of local flaps, were managed using a DPF to reconstruct the defect following a vertical incision release of the stenotic band down to the inferior tracheal cartilaginous ring. Healing absence of restenosis, alleviation of the symptoms of difficulty in breathing and clearance of secretions were considered a successful composite endpoint.
Over a median follow-up period of 11 months all patients maintained patency, and symptoms of difficulty in breathing and clearing of secretions were alleviated.
The deltopectoral flap is a rapid, reliable flap for the management of tracheostomal stenosis in irradiated patients. It brings well-vascularised tissue into the site of reconstruction and, in the short term, stomal patency and symptom relief were achieved.
气管造口狭窄是喉切除术后一种发生率较高的令人痛苦的并发症。我们旨在评估肩胛胸皮瓣（DPF）在接受放疗的患者中用于气管造口狭窄矫正的效果。
6 例气管造口狭窄患者，其中 3 例在使用局部皮瓣后出现再狭窄，采用 DPF 通过垂直切口释放狭窄带至下气管软骨环来重建缺损。愈合无再狭窄、呼吸困难症状缓解和分泌物清除被认为是成功的综合终点。
在中位随访 11 个月期间，所有患者均保持通畅，呼吸困难和分泌物清除症状得到缓解。
肩胛胸皮瓣是一种快速、可靠的皮瓣，可用于治疗放疗后患者的气管造口狭窄。它将血运良好的组织带入重建部位，短期内实现了造口通畅和症状缓解。
