COVID-19 大流行期间食管癌切除术前的锁骨上动脉皮瓣口腔重建：病例报告。
Supraclavicular Artery Flap for Oral Reconstruction Prior to Esophagectomy During the COVID-19 Pandemic: A Case Report.
机构信息
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan;
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
出版信息
In Vivo. 2021 Nov-Dec;35(6):3597-3601. doi: 10.21873/invivo.12665.
BACKGROUND
During the coronavirus disease 2019 (COVID19) pandemic, pedicle flaps (instead of free flaps) were recommended for reconstruction following wide resection for patients with head and neck cancer, in order to reduce the use of medical resources. Currently, there are no established treatment guidelines for patients with head and neck cancer with synchronous esophageal cancer.
CASE REPORT
We present a 68-year-old male with cT4aN2cM0 oral floor and synchronous cT1bN1M0 esophageal cancers who had defective reconstruction following oral tumor resection before esophagectomy during the pandemic. At the initial surgery, the oral resected defect was reconstructed using supraclavicular artery flap. The subsequent esophagectomy was reconstructed by gastric tube reconstruction. Both postoperative courses were successful, without the need for postoperative ventilator use. The days from initial or second surgery to discharge were 14 or 16 days, respectively.
CONCLUSION
This case had achieved negative surgical margins and recovered oral intake with tracheostomy decannulation. Further case accruement using supraclavicular artery flap is required for patients with head and neck cancer and synchronous esophageal cancer.
背景
在 2019 年冠状病毒病（COVID-19）大流行期间，为了减少医疗资源的使用，建议头颈部癌症患者在广泛切除后使用皮瓣（而非游离皮瓣）进行重建。目前，对于同时患有头颈部癌症和食管癌的患者，尚无既定的治疗指南。
病例报告
我们报告了一名 68 岁男性患者，患有口腔 floor 的 cT4aN2cM0 和同步的 cT1bN1M0 食管癌，在大流行期间，在接受食管切除术之前，他因口腔肿瘤切除后存在缺陷而无法进行重建。在初始手术中，使用锁骨下动脉皮瓣重建口腔切除缺损。随后的食管切除术采用胃管重建。两次手术后的恢复过程均成功，无需术后使用呼吸机。初次手术或二次手术后的出院天数分别为 14 天或 16 天。
结论
该病例实现了阴性手术切缘，并在气管造口拔管后恢复了经口进食。需要进一步积累使用锁骨下动脉皮瓣治疗头颈部癌症和同步食管癌患者的病例。
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