Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, P.R. China.
BMC Surg. 2020 Nov 25;20(1):299. doi: 10.1186/s12893-020-00972-9.
Large or complex trachea defects often require some tissue to reconstruct, various flaps have been reported for reconstructing this defect. However, pedicled thoracoacromial artery perforator flap have not been reported in tracheal reconstruction. Therefore, this study is to assess the efficacy and clinical application of pedicled thoracoacromial artery perforator flaps for tracheal reconstruction.
Eight patients who underwent tracheal reconstructions with pedicled TAAP flaps between December 2017 and October 2019 were retrospectively reviewed.
All of the pedicled TAAP flaps in our study survived. The flap size ranged from 2 cm × 5 cm to 4 cm × 10 cm, and the size of each island of one double-island flap was 2 cm × 2.5 cm. The mean thickness was 0.6 cm, and the pedicle length varied between 6 and 9 cm (mean 7.9 cm). The mean time of flap harvest was 17 min. The mean age of the patients was 62.4 years and five elderly patients had comorbidities, such as diabetes, hypertension and asthma. One patient received a double-island flap for tracheal and esophageal reconstruction, and the other patient received simple tracheal reconstruction. One patient died due to cancer metastasis. Six patients obtained functional recovery of breathing, except one patients who did not experience closure of the tracheostomy opening due to uncompleted I131 treatment.
Pedicled TAAP flaps provide a short harvesting time, thin thickness and stable blood supply, and they do not require microsurgical skills. This flap is a good choice for the reconstruction of tracheal defects, especially in the aged or patients with comorbidities who are not able to tolerate prolonged surgery.
大或复杂的气管缺损常需要一些组织来重建，已有多种皮瓣用于重建这种缺损。然而，带蒂的胸肩峰动脉穿支皮瓣在气管重建中尚未报道。因此，本研究旨在评估带蒂胸肩峰动脉穿支皮瓣在气管重建中的疗效和临床应用。
回顾性分析 2017 年 12 月至 2019 年 10 月期间 8 例行带蒂 TAAP 皮瓣气管重建术的患者。
本研究中所有带蒂 TAAP 皮瓣均存活。皮瓣大小为 2 cm×5 cm 至 4 cm×10 cm，双岛皮瓣每个岛的大小为 2 cm×2.5 cm。平均厚度为 0.6 cm，蒂长 6-9 cm（平均 7.9 cm）。皮瓣切取时间平均为 17 分钟。患者平均年龄为 62.4 岁，5 例老年患者合并糖尿病、高血压和哮喘等疾病。1 例患者行双岛皮瓣同时行气管和食管重建，另 1 例患者行单纯气管重建。1 例患者死于癌症转移。6 例患者呼吸功能恢复，1 例患者因 I131 治疗未完成未关闭气管造口。
带蒂 TAAP 皮瓣具有切取时间短、皮瓣薄、血供稳定等优点，且不需要显微外科技术。对于气管缺损的重建，该皮瓣是一种较好的选择，特别是对于不能耐受长时间手术的老年或合并症患者。
