颈阔肌皮瓣修复或重建颈部食管缺损术后并发症探讨

Postoperative Complication of Reconstruction or Repair Defect of Cervical Esophagus Using Platysma Myocutaneous Flap

目的 探讨颈阔肌皮瓣重建或修复颈部食管缺损术后常见并发症的预防和治疗。 方法 对我科 1989年 6月至 2 0 0 1年 6月采用双侧颈阔肌皮瓣重建颈段食管缺损 15例 ,单侧颈阔肌皮瓣修复颈段食管缺损 2 3例进行回顾性分析。 结果 全组无手术死亡 ,肌皮瓣全部成活 ,6例发生吻合口瘘 ,更换敷料后愈合 ;吻合口狭窄 2例 ,1例经扩张后治愈 ,另 1例经再次手术恢复 ,所有患者均能正常经口进食。 结论 颈阔肌皮瓣重建或修复下咽及颈段食管缺损 ,具有创伤小、转移就近方便、能一期完成手术、术后并发症少等优点 。

Objective To discuss the postoperative complication of reconstruction or repair defect of cervical esophagus using platysma myocutaneous flaps(PMF). Methods Retrospective analysis 15 patients of hypophargngeal carcinoma were reconstructed by PMF of both sides after resection of total larynx, pharynx and cervical esophagus, 23 cases with stricture of cervical esophagus were repaired by PMF of one side in our department from June 1989 to June 2001. Results There was no death after operation. All the flaps survived, 6 patients suffered from fistula of cervical anastomosis after operation and they healed with conservative dressing. Stricture of cervical anastomosis 2 cases , one patient healed with dilatation and another one treated by reoperation, other patients were able take solid foods with comfort in early stage. Conclusion The advantages of repairing stricture or reconstructing the defect of cervical esophagus with PMF are that the operative wound is small, the procedure is convenient for transference and can be completed in one stage, the postoperative complication is low. Worthy of extending application in the clinic.