- 期刊
Free Anterolateral Thigh Flap for Pharyngoesophageal Reconstruction
使用自由前外側股皮瓣用於咽食道重建
摘要
一位44歲罹患下咽癌的男性患者，接受全咽喉食道切除，使用自由前外側股皮瓣併股外側肌，用於重建全層咽食道缺損。三重縫合方式用以避免食道滲漏，其中包括最內層表皮一黏膜層，第二層筋膜－肌肉層，最外層股外側肌層。在皮瓣下端設計二個三角形延伸，造成與食道交錯縫合，以防止術後食道窄縮。下端股外側肌翻出植皮，用以監側自由皮瓣。術後皮瓣存活良好。追蹤的食道攝影與頸部電腦斷層，顯示咽食道部有良好的通暢性。患者在術後第18和28天，開始進食流質與半固體食物而無感染與食道滲漏，窄縮。使用捲成管狀的自由前外側股皮瓣，用於咽食道重建的優點，將被加以討論。
關鍵字
無資料並列摘要
A 44 year-old man of hypopharyngeal cancer underwent total laryngopharyngoesophagectomy. A free anterolateral thigh flap with vastus later- ails muscle was designed for reconstruction of the circumferential pharyngoesophageal defect. The triple-layer design including the skin for the innermost lining, fascia lata in the middle layer and the vastus lateralis muscle for the outermost coverage was designed to prevent the anastomotic leakage. To avoid stricture formation, two triangular extensions of the caudal end of the flap was created for a staggered anastomosis. The lower portion of the transferred vastus lateralis muscle was exteriorized and covered with a meshed skin graft for the flap monitoring. The flap survived completely. The follow-up esophagography and neck computer tomography revealed good patency of the neo-pharyngoesophagus. The patient could tolerate liquid diet well 18 days postoperatively without any complication of infection, leakage of stenosis. The advantages of anterolateral thigh flap as a tubed skin flap for pharyngoesophageal reconstruction are discussed in this article.
延伸閱讀
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