游离空肠移植因血管吻合处暂时性阻塞致瘢痕性狭窄1例

Ryotaro Nakazawa, K. Akashi, S. Kishimoto
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引用次数: 0

摘要

晚期头颈癌患者行全咽喉喉食管切除术(TPLE)。其次是游离空肠瓣咽食管重建术,手术风险相对较低,并能改善重建后咽食管功能。一名79岁男性患下咽癌,在我院行TPLE、两侧颈部清扫、游离空肠转移术。术后早期,由于动脉吻合区梗阻,我们进行了取栓术。早期取栓可改善血流,皮瓣存活。然而,瘢痕性狭窄逐渐达到全长,因此我们再次进行自由空肠转移。病理结果显示粘膜萎缩消失,血管保存完好。即使游离空肠瓣在TPLE术后早期因血管问题再次手术后存活,也可能逐渐形成瘢痕和狭窄。
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A case of scarring stenosis of the transferred free jejunum due to temporary obstruction of the vascular anastomosis site
of the transferred free jejunum due to temporary obstruction of the vascular anastomosis site: Total pharyngolaryngoesophagectomy (TPLE) is performed on patients with advanced head and neck cancer. It is most frequently followed by pharyngoesophageal reconstruction with free jejunal flap because there is a relatively low operative risk and it improves postoperative function of the reconstructed pharynx and esophagus. A 79-year-old man developed hypopharyngeal carcinoma and underwent TPLE, neck dissection on both sides, and free jejunal transfer at our hospital. Early after surgery, we conducted thrombectomy because obstruction by the artery anastomotic region occurred. Blood flow was improved by early thrombectomy, and the flap sur-vived. However, a scarring stenosis which gradually reached full length occurred, and so we performed free jejunal transfer again. The pathological findings indicated that the mucosa had atrophied and been lost, while blood vessels were preserved. Even if the free jejunal flap survives early reoperation for vascular problems after TPLE, it may gradually develop scarring and stenosis.
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来源期刊
Japanese Journal of Head and Neck Cancer
Japanese Journal of Head and Neck Cancer Medicine-Otorhinolaryngology
CiteScore
0.10
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发文量
7
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