Nakatsuka T, Harii K, Ebihara S, Hirano K, Haneda T, Hayashi R, Nibu K, Ichimura K
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tokyo, Japan.
Ann Plast Surg. 1996 Dec;37(6):596-603.
Free transverse colon transfers based on the middle colic vessels were used to reconstruct a pharyngoesophageal defect in 9 patients. In all patients, cancer invaded up to the oropharynx. Resection resulted in a larger pharyngostoma than normally seen following standard total pharyngolaryngoesophagectomy. In such cases, it can be difficult to achieve good swallowing function after reconstruction using the free jejunal transfer. This mainly results from a significant discrepancy between the diameter of the pharyngostoma and that of the jejunum. Compared to the jejunum, the transverse colon has a larger diameter with a longer vascular pedicle and can provide a longer, straight intestinal tube, facilitating easy passage of a food bolus. In our series, all transfers survived well and all patients had good swallowing function postoperatively. We consider that a free colon transfer is more suitable than a free jejunal transfer for pharyngoesophageal reconstruction in patients with a large pharyngostoma.
采用基于中结肠血管的游离横结肠转移术对9例患者的咽食管缺损进行重建。所有患者的癌症均侵犯至口咽。切除术后形成的咽瘘口比标准全喉咽食管切除术后通常所见的更大。在这种情况下，使用游离空肠转移术重建后难以实现良好的吞咽功能。这主要是由于咽瘘口直径与空肠直径存在显著差异。与空肠相比，横结肠直径更大，血管蒂更长，能够提供更长、更直的肠管，有利于食团顺利通过。在我们的系列病例中，所有转移的结肠均存活良好，所有患者术后吞咽功能良好。我们认为，对于咽瘘口较大的患者，游离结肠转移术比游离空肠转移术更适合用于咽食管重建。
