Delayed Arteriovenous Fistulae Formation-A Rare Complication of Free Flap Surgery

自由皮瓣手術後之延遲性動靜脈瘻管生成

邱大睿(Ta-jui Chiu) ； 張世幸(Shih-Hsin Chang) ； 董光義(Kwan-Yi Tung) ； 蕭弘道(Hung-Tao Hsiao)

《中華民國整形外科醫學會雜誌》 18卷2期 (2009/06) Pp. 176-182

https://doi.org/10.7096/JPSA.200906.0176

摘要

背景
動靜脈瘻管是一種不正常的動脈與靜脈之間的連結。外科手術是產生動靜脈瘻管的可能原因之一。
目的與目標
我們在此要提出一病例報告一位口腔癌病人接受自由皮瓣重建手術，術後產生延遲性動靜脈瘻管之治療經驗。
來源與方法
這是一位三十八歲男性病患，患有復發性之口腔癌並接受腫瘤切除與前外側大腿自由皮瓣重建手術治療。接受手術後一年，發現頸部有動靜脈瘻管產生，並以電腦斷層與血管攝影作診斷。診斷後病人接受結紮與切除此動靜脈瘻管手術治療。
結果
病人接受手術治療後原皮瓣仍存活完整。且在術後兩年追蹤中，並沒有發現動靜脈瘻管有復發的狀況。
結論
自由皮瓣重建手術術後導致動靜脈瘻管的後遺症是少見的狀況。手術結紮與切除此瘻管可以達到良好的治療效果。

並列摘要

Background:
An arteriovenous (AV) fistula is an abnormal communication between artery and vein. Surgery is a possible reason to cause an acquired arteriovenos fistula.
Aim and Objectives:
In this paper, we present our experience of treating a patient who was a victim of delayed arteriovenous fistula formation after free flap reconstruction for oral cancer.
Materials and Methods:
This 38-year-old male was a victim of recurrent buccal cancer. He received ablation surgery of the recurrent cancer with free anteriolateral thigh flap reconstruction. One year later, a neck arteriovenous fistula was found by CT scan and angiography. Operation for ligation and excision of the arteriovenous fistula was performed.
Results:
After the operation, the flap survived well. There was no local recurrence of the fistula noted during the post-operative follow up for 2 years.
Conclusion:
A delayed arteriovenous fistula resulted from the free flap reconstructive surgery is a rare complication. The surgery of excision and ligation of the fistula yields the best results in the case.

並列關鍵字

arteriovenous fistula ； free flap reconstructive surgery