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带蒂胸大肌肌皮瓣:食管重建中的一种挽救性选择。

Tubed myocutaneous pectoralis major flap: A rescue option in esophagus reconstruction.

作者信息

Caixeiro L, Lanzaro L, Soares C, Oliveira P, Gaspar C, Zenha H, Costa H

机构信息

Division of Plastic, Reconstructive, Maxillofacial surgery, Hand and Microsurgery Unit, Gaia Hospital Center, Portugal.

Aveiro University, Portugal.

出版信息

JPRAS Open. 2024 Feb 24;40:138-144. doi: 10.1016/j.jpra.2024.02.011. eCollection 2024 Jun.

Abstract

This article presents a complex case of total pharyngoesophageal defect reconstruction in a patient with recurrent supraglottic squamous cell carcinoma. After failed attempts with free microsurgical techniques due to complications, a tubed myocutaneous pectoralis major flap was successfully employed. The procedure aimed to achieve alimentary continuity, speech, and swallowing functionality. Despite initial challenges and concerns about stenosis, the reconstruction of a total pharyngolarygectomy defect resulted in a good functional outcome, although minor deficits in neck mobility and aesthetic donor zone deformities were noted. The case highlights the broad armamentarium of reconstruction techniques that plastic and aesthetic surgery teams must be trained, namely the myocutaneous pectoralis major flap which in selected cases can be the end solution.

摘要

本文介绍了1例复发性声门上鳞状细胞癌患者全咽食管缺损重建的复杂病例。由于并发症,游离显微外科技术尝试失败后,成功采用了管状胸大肌肌皮瓣。该手术旨在实现消化道连续性、言语和吞咽功能。尽管最初存在狭窄方面的挑战和担忧,但全喉咽切除术缺损的重建仍取得了良好的功能结果,不过颈部活动度有轻微缺陷,供区出现了美学畸形。该病例凸显了整形和美容外科团队必须掌握的广泛重建技术,即胸大肌肌皮瓣,在某些情况下它可能是最终解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e5d/11156692/cf586c56a399/gr1.jpg

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