Chen H C, Tang Y B, Shieh M J, Chang C H, Noordhoff M S
Chang Gung Memorial Hospital, Taipei, Taiwan.
Ann Thorac Surg. 1988 Jan;45(1):39-42. doi: 10.1016/s0003-4975(10)62392-2.
In 24 patients, corrosive injuries involving the floor of the mouth, the pharynx, and the esophagus were repaired in two stages using a combined free forearm flap and colon for functional restoration of the alimentary tract. The results were satisfactory. Morbidity was decreased, complications were minimal, and there were no failures. In the first stage, early reconstruction with a forearm flap for the oral floor, the pharynx, and the cervical esophagus can be done safely 3 months after the original injury when the acute inflammation of the tissue has disappeared. The forearm flap is thin and pliable, and has a good blood supply for primary healing without failure or stricture. Dysphagia is eliminated because food passes down by gravity. There is no constriction or hyperperistalsis of the colon, both of which are occasionally seen with the traditional colon interposition. In the second stage, the traditional method is used to finish the reconstruction of the remainder of the esophagus.
对24例口底、咽和食管腐蚀性损伤患者分两期进行修复，采用游离前臂皮瓣联合结肠移植以恢复消化道功能。结果满意。发病率降低，并发症极少，无一例失败。第一期，在原发损伤3个月后，当组织急性炎症消退时，可安全地用前臂皮瓣对口腔底部、咽和颈段食管进行早期重建。前臂皮瓣薄而柔韧，血供良好，利于一期愈合，无失败或狭窄情况。吞咽困难得以消除，因为食物靠重力下行。结肠无狭窄或蠕动亢进，而这在传统结肠间置术中偶尔会出现。第二期，采用传统方法完成食管其余部分的重建。
