带蒂背阔肌肌皮瓣治疗获得性气管食管瘘合并气管皮肤瘘一例

Pedicled latissimus dorsi myocutaneous flap for treatment of acquired tracheoesophageal fistula combined with tracheocutaneous fistula:A case report

1例56岁男性患者,因脑外伤行去骨瓣减压术,术后机械通气治疗30^(+)d,气切套管拔除后发现气管食管瘘合并气管皮肤瘘并转入我院。我们进行了气管切除术加食管瘘口修补术,并在气管前方与食管前方予以带蒂背阔肌肌皮瓣修补。患者术后24 d顺利出院行后续神经康复治疗,出院时可正常经口进食。

We reported a patient intubated for more than 30 d following brain injury,transferred to our department with tracheocutaneous fistula and a 2 cm fistula between the trachea and the esophagus.We performed tracheal resection and esophageal closure with a latissimus dorsi myocutaneous flap interposed between suture lines.The patient continued mechanical ventilation after surgery and the tracheotomy was achieved 14 d after the beginning of surgical treatment.The patient was started oral feeding and discharged on the 10 d after tracheotomy and referred to a neuromotor recovery clinic for treatment of post-traumatic sequelae.