Richardson J D, Tobin G R
Department of Surgery, University of Louisville, School of Medicine. Ky.
Arch Surg. 1994 May;129(5):541-7; discussion 547-8. doi: 10.1001/archsurg.1994.01420290087013.
To determine the feasibility and reliability of muscle flaps as a sole means of closure of severe esophageal defects.
Retrospective case series of patients with esophageal defects closed with muscle flaps. Mean follow-up was 6 years.
A university hospital and a tertiary care, university-affiliated, private hospital.
Fourteen patients with esophageal defects that could not be closed by standard suture techniques or failed to close with observation alone.
Survival, continued esophageal leakage, restoration of esophageal continuity, and long-term esophageal function.
There was one operative death and one delayed death, both unrelated to the esophageal injury. There were five early leaks that healed promptly. Esophageal continuity was restored in all patients. Long-term esophageal function has been excellent.
The use of primary muscle repair for esophageal defects not amenable to standard closure techniques provides an excellent means of closing esophageal wounds and restoring esophageal continuity. This option appears to be preferable to other more destructive options in managing this serious problem.
确定肌瓣作为闭合严重食管缺损的唯一手段的可行性和可靠性。
对采用肌瓣闭合食管缺损的患者进行回顾性病例系列研究。平均随访6年。
一家大学医院和一家大学附属的三级护理私立医院。
14例食管缺损患者，这些缺损无法通过标准缝合技术闭合或仅观察无法闭合。
生存率、持续性食管漏、食管连续性恢复以及长期食管功能。
有1例手术死亡和1例延迟死亡，均与食管损伤无关。有5例早期漏，均迅速愈合。所有患者的食管连续性均得以恢复。长期食管功能良好。
对于不适合标准闭合技术的食管缺损，采用一期肌瓣修复可提供一种闭合食管伤口和恢复食管连续性的良好方法。在处理这一严重问题时，该方法似乎比其他更具破坏性的方法更可取。
