Anterolateral Thigh Flap in Pharyngoesophageal Reconstruction with Easy Flap Monitoring

大腿前外側皮瓣於咽食道重建的應用及皮瓣的監測

簡睿宏(Jui-Hung Chien) ； 王志信(Chih-Hsin Wang) ； 張舜程(Shun-Cheng Chang) ； 陳天牧(Tim-Mo Chen) ； 陳紹良(Shao-Liang Chen)

《臺灣整形外科醫學會雜誌》 19卷3期 (2010/09) Pp. 181-188

https://doi.org/10.7096/TJTSPS.201009.0181

摘要

背景：
使用大腿前外側皮瓣重建咽食道，是屬於一種埋藏性的游離皮瓣移植，在這種情況下，皮瓣的監測是很重要的。在這裡，我們報告關於使用大腿前外側皮瓣重建咽食道的經驗。
方法：
從2006年7月至2009年6月，共7位接受咽食道重建手術的病患進行非侵入性的研究，所有病患皆爲男性，平均年齡49歲，咽食道缺損從6至11公分不等（平均8.07公分），因腫瘤切除後導致整圈食道缺損的病患有4位，所有病患皆使用大腿前外側皮瓣重建。
結果：
所有病患皆使用獨立的遠端穿通支皮瓣來進行監測，這些病患的皮瓣都存活下來，不需要拯救的步驟。
結論：
對咽食道重建來說，大腿前外側皮瓣是一種好用的皮瓣，它只需要一階段的手術步驟，包括填補頸部空間及皮膚的缺損，並可利用獨立的遠端穿通枝皮瓣來進行監測。

並列摘要

Background:
Pharyngoesophageal reconstruction with the anterolateral thigh (ALT) flap involves a buried free tissue transfer, and flap monitoring is important in this situation. Here we review our experience in pharyngoesophageal reconstruction using the ALT flap.
Methods:
Seven patients receiving pharyngoesophageal reconstruction (July 2006 through June 2009) were investigated noninvasively. All the patients were men with a mean age of 49 years. The pharyngoesophageal defects ranged from 6 to 11 cm in length (mean 8.07 cm), and circumferential defects were created after tumor ablation in four patients. Free ALT flaps were used in all patients for reconstruction and flap monitoring using an isolated distal perforator cutaneous flap was applied.
Results:
All reconstructive flaps survived in these patients without the need for a salvage procedure.
Conclusions:
The ALT is a useful flap for pharyngoesophageal reconstruction. It provides a single-stage procedure, including space filling, resurfacing of the neck skin and reliable flap monitoring.

並列關鍵字

Pharyngoesophageal reconstruction ； Anterolateral thigh flap