A 53-year-old male developed cervical esophageal stenosis after esophageal bypass surgery using a right colon conduit.The esophageal bypass surgery was performed to treat multiple esophageal strictures resulting from ...A 53-year-old male developed cervical esophageal stenosis after esophageal bypass surgery using a right colon conduit.The esophageal bypass surgery was performed to treat multiple esophageal strictures resulting from corrosive ingestion three years prior to presentation.Although the patient underwent several endoscopic stricture dilatations after surgery,he continued to suffer from recurrent esophageal stenosis.We planned cervical patch esophagoplasty with a pedicled skin flap of sternocleidomastoid(SCM) muscle.Postoperative recovery was successful,and the patient could eat a solid meal without difficulty and has been well for 18 mo.SCM flap esophagoplasty is an easier and safer method of managing complicated and recurrent cervical esophageal strictures than other operations.展开更多
Objective： To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods： From June 2007 to June 2012,...Objective： To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods： From June 2007 to June 2012, five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps. The patients were 27-61 years old with 4 male cases and 1 female. The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference. Results： M1 five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps, with no tracheal stricture remaining and vomica successfully eliminated. During the first 1 to 3 months after the operation, bronchoscopy showed that the tracheal lumens were smooth, and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge. Conclusions： Despite this being a small series and short follow-up, this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.展开更多
Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, pe...Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, peculiarity and etiological factor of wound. There were 28 cases of island pectoralis major island myocutanuous flaps, 34 cases of latissimus dorsi island myocutaneous flaps, 19 cases of trapizius island myocutaneous flaps and 17 cases of rectus abdominis island myocutaneous flaps in this report. Results: All 98 patients with challenging wound on cervico-thoracic region were successfully treated with this method without complications, and obtained functional and cosmetic effectiveness. Conclusion:Challenging wounds in cervico-nuchal region can be repaired with pertoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap and trapizius island myocutaneous flap, while challenging wounds in thoracic region can be repaired with latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. Satisfactory functional and cosmetic results can be obtained.展开更多
The pectoralis major myocutaneous pedicle flap (PMMF) is still being used by many surgeons and plays an important role in head and neck reconstruction. The purpose of this series was to review our 10 years’ experienc...The pectoralis major myocutaneous pedicle flap (PMMF) is still being used by many surgeons and plays an important role in head and neck reconstruction. The purpose of this series was to review our 10 years’ experience with the PMMF in head and neck reconstruction. One hundred and two patients who underwent the PMMF technique were reviewed on the clinical records. Postoperative complications were classified into flap loss, hemorrhage, infection, fistula formation, wound dehiscence and donor site complication. Eighty two patients (80.4%) demonstrated no complication. Six patients among 102 patients (5.9%) demonstrated total or partial skin necroses. Three female patients were completely dissatisfied with the cosmetic appearance after the PMMF. One of them required a reconstructive surgery with the latissimusdorsi flap. Without surgical expertise in plastic surgical field, an ear-nose-throat or an oral surgeon can performed the PMMF technique provided the operator is well aware of serious and frequent complications of this “workhorse” procedure.展开更多
Perioperative airway management in patients with oro-facial cancers who has undergone chemo/or radiotherapy poses a great challenge to the anaesthesiologist. These challenges are mainly due to either a mass in the ora...Perioperative airway management in patients with oro-facial cancers who has undergone chemo/or radiotherapy poses a great challenge to the anaesthesiologist. These challenges are mainly due to either a mass in the oral cavity or a limited mouth opening making intubation difficult or a major facial defect making mask ventilation difficult. We present our first time experience in a 27-year-old man with a malignant lymphoma of the right cheek who had undergone chemotherapy and needed plastic surgery to restore the face.展开更多
Objective： To evaluate the results of repairing large defect on abdominal wall with artificial meshes（expansible polytetrafluoroethylene, e-PTFE and Composix Mesh）. Methods： Four cases with large defect of abdomin...Objective： To evaluate the results of repairing large defect on abdominal wall with artificial meshes（expansible polytetrafluoroethylene, e-PTFE and Composix Mesh）. Methods： Four cases with large defect of abdominal wall caused by abdominal wall tumors or injuries were repaired with artificial meshes and myocutaneous flaps. Results： The cases were followed up 7 months to 2.5 years with no complications such as incisional hernia, bowel adhesion and exposure of the prosthetic materials. Conclusion： The combined use of artificial meshes contained e-PTFE and myocutaneous flaps is a reliable and effective method for repairing large defect on abdominal wall.展开更多
The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evo...The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evolved and recently free tissue transfer has played an important role in head and neck reconstruction. Although we use free flaps as the first choice for head and neck reconstruction, similar to many other institutions, some patients at our hospital have undergone reconstruction with PMMC flaps. We retrospectively analyzed the indications and outcomes of this reconstructive technique from our experience with 12 patients. The medical records of all patients who underwent PMMC flaps at Hokkaido Cancer Center from 2001 to 2010 were reviewed. Data concerning diagnosis, main indication, site of reconstruction, previous treatment, and postoperative complications were analyzed. Of the 12 PMMC flap surgeries performed, 3 were carried out as primary reconstructive procedures, whereas 9 were done as “salvage” procedures. Flap-related complications were observed in 6 cases. Partial flap loss developed in 4 patients, although there were no cases of total flap loss. There were 3 recurrent fistulae following reconstruction with PMMC flaps. The preoperative goals of performing PMMC flap surgery were met in 83% of our cases. The authors conclude that while free flap transfer is usually the first choice for head and neck reconstruction, PMMC flaps can produce acceptable results in certain situations.展开更多
· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved ...· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.展开更多
Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For...Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis.展开更多
文摘A 53-year-old male developed cervical esophageal stenosis after esophageal bypass surgery using a right colon conduit.The esophageal bypass surgery was performed to treat multiple esophageal strictures resulting from corrosive ingestion three years prior to presentation.Although the patient underwent several endoscopic stricture dilatations after surgery,he continued to suffer from recurrent esophageal stenosis.We planned cervical patch esophagoplasty with a pedicled skin flap of sternocleidomastoid(SCM) muscle.Postoperative recovery was successful,and the patient could eat a solid meal without difficulty and has been well for 18 mo.SCM flap esophagoplasty is an easier and safer method of managing complicated and recurrent cervical esophageal strictures than other operations.
文摘Objective： To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor. Methods： From June 2007 to June 2012, five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps. The patients were 27-61 years old with 4 male cases and 1 female. The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference. Results： M1 five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps, with no tracheal stricture remaining and vomica successfully eliminated. During the first 1 to 3 months after the operation, bronchoscopy showed that the tracheal lumens were smooth, and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge. Conclusions： Despite this being a small series and short follow-up, this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.
文摘Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, peculiarity and etiological factor of wound. There were 28 cases of island pectoralis major island myocutanuous flaps, 34 cases of latissimus dorsi island myocutaneous flaps, 19 cases of trapizius island myocutaneous flaps and 17 cases of rectus abdominis island myocutaneous flaps in this report. Results: All 98 patients with challenging wound on cervico-thoracic region were successfully treated with this method without complications, and obtained functional and cosmetic effectiveness. Conclusion:Challenging wounds in cervico-nuchal region can be repaired with pertoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap and trapizius island myocutaneous flap, while challenging wounds in thoracic region can be repaired with latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. Satisfactory functional and cosmetic results can be obtained.
文摘The pectoralis major myocutaneous pedicle flap (PMMF) is still being used by many surgeons and plays an important role in head and neck reconstruction. The purpose of this series was to review our 10 years’ experience with the PMMF in head and neck reconstruction. One hundred and two patients who underwent the PMMF technique were reviewed on the clinical records. Postoperative complications were classified into flap loss, hemorrhage, infection, fistula formation, wound dehiscence and donor site complication. Eighty two patients (80.4%) demonstrated no complication. Six patients among 102 patients (5.9%) demonstrated total or partial skin necroses. Three female patients were completely dissatisfied with the cosmetic appearance after the PMMF. One of them required a reconstructive surgery with the latissimusdorsi flap. Without surgical expertise in plastic surgical field, an ear-nose-throat or an oral surgeon can performed the PMMF technique provided the operator is well aware of serious and frequent complications of this “workhorse” procedure.
文摘Perioperative airway management in patients with oro-facial cancers who has undergone chemo/or radiotherapy poses a great challenge to the anaesthesiologist. These challenges are mainly due to either a mass in the oral cavity or a limited mouth opening making intubation difficult or a major facial defect making mask ventilation difficult. We present our first time experience in a 27-year-old man with a malignant lymphoma of the right cheek who had undergone chemotherapy and needed plastic surgery to restore the face.
文摘Objective： To evaluate the results of repairing large defect on abdominal wall with artificial meshes（expansible polytetrafluoroethylene, e-PTFE and Composix Mesh）. Methods： Four cases with large defect of abdominal wall caused by abdominal wall tumors or injuries were repaired with artificial meshes and myocutaneous flaps. Results： The cases were followed up 7 months to 2.5 years with no complications such as incisional hernia, bowel adhesion and exposure of the prosthetic materials. Conclusion： The combined use of artificial meshes contained e-PTFE and myocutaneous flaps is a reliable and effective method for repairing large defect on abdominal wall.
文摘The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evolved and recently free tissue transfer has played an important role in head and neck reconstruction. Although we use free flaps as the first choice for head and neck reconstruction, similar to many other institutions, some patients at our hospital have undergone reconstruction with PMMC flaps. We retrospectively analyzed the indications and outcomes of this reconstructive technique from our experience with 12 patients. The medical records of all patients who underwent PMMC flaps at Hokkaido Cancer Center from 2001 to 2010 were reviewed. Data concerning diagnosis, main indication, site of reconstruction, previous treatment, and postoperative complications were analyzed. Of the 12 PMMC flap surgeries performed, 3 were carried out as primary reconstructive procedures, whereas 9 were done as “salvage” procedures. Flap-related complications were observed in 6 cases. Partial flap loss developed in 4 patients, although there were no cases of total flap loss. There were 3 recurrent fistulae following reconstruction with PMMC flaps. The preoperative goals of performing PMMC flap surgery were met in 83% of our cases. The authors conclude that while free flap transfer is usually the first choice for head and neck reconstruction, PMMC flaps can produce acceptable results in certain situations.
基金Supported by Jilin Province Science and Techology Development Plan Project(No.20150414032GH)
文摘· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.
文摘Local flaps are widely known as the best option for partial nasal reconstructions depending on donor tissue laxity,vascularization,and defect shape and size.The nasolabial flap is used more often in the nasal sill.For larger defects,greater tissue mobilization with larger scars or free flaps is required.Historically,the Abbe flap has been used for lip reconstruction in patients with cleft lip deformities.It allows less retraction than other local flaps or skin grafts in patients with large defect sizes and great defect depths.This study reported on the application of the Abbe flap for nasal sill reconstruction on a 71-year-old female patient with nasal sill basal cell carcinoma who had undergone resection surgery with a posterior lip switch operation with satisfactory results.The application of the Abbe flap could be considered in patients with multiple previous surgeries and at risk for necrosis.
