Using the Cephalic Vein Transposition as a Recipient Venous Drainage for Difficult Head and Neck Reconstructions

以翻轉頭靜脈作為頭頸部顯微重建之靜脈引流

孫宗伯(Tzong-Bor Sun) ； 簡守信(Sou-Hsin Chien) ； 徐莉萍(Lee-Ping Hsu) ； 陳培榕(Peir-Rong Chen) ； 王建興(Chien-Hsing Wang) ； 黃介琦(Chieh-Chi Huang) ； 鄭立福(Li-Fu Cheng) ； 李俊達(Jiunn-Tat Lee)

《中華民國整形外科醫學會雜誌》 12卷3期 (2003/09) Pp. 151-156

https://doi.org/10.7096/JPSA.200309.0151

摘要

基於頭頸部腫瘤治療方法的進步，愈來愈多的復發性腫瘤與多發性腫瘤病患尋求積極的手術治療。於少數的情況下，因多次手術與放射線治療，致使顯微重建手術時，無法尋獲適當的接受靜脈，提供游離皮瓣靜脈回流，提高重建手術的困難度。本研究之目的即再於對此一難題，提供合理且有效的解決方法。
慈濟醫學中心頭頸部腫瘤治療團隊，於過去的30個月中，從事了109例頭頸部顯微重建，其中6例缺乏合宜的頸部靜脈作為皮辦靜脈回流吻合之用，計算其發生率為5.5%。經應用翻轉頭靜脈之方法，將頭靜脈於上臂遠端分離、截斷，向近心端逐步游離並轉位至頸部，所有病患皆可順利的完成游離皮瓣移植手術，且皮瓣存活率達100%，平均重建手術時間為390±28.77分鐘，與一般病患所耗時間無統計上差異。本研究結果顯示使用翻轉頭靜脈技術，可以對缺乏適當靜脈回流的困難頭頸部重建，提供有效的解決方法。

並列摘要

It is sometimes difficult to have a proper recipient vein for free tissue transfer in repeated or radiated head and neck reconstructions. The purpose of this article is to report our experience of using cephalic vein transpositions in difficult recipient beds in the necks.
One hundred and nine free tissue transfers were performed for head and neck reconstruction in Buddhist Tzu Chi Medical Center between September 2000 and March 2003. Six cases without available recipient veins in the necks had used the cephalic vein transposition for drainage. The cephalic veins were dissected free from the upper limb for an adequate length and turned up to the neck as recipient veins for microvascular anastomoses with the pedicle veins of the free flaps. The incidence of using the cephalic vein transposition is 5.5%. All of the six free flaps survived and healed primarily. The reconstruction time was 390.33±28.77 minutes, which was similar to that of other patients (381.02±6.83) using neck veins. The cephalic vein transposition from the arm proves to be a reliable alternative recipient vein for microvascular head and neck reconstruction when there are no suitable veins in the necks.

並列關鍵字

head and neck ； reconstructive microsurgery ； cephalic vein transposition