Free jejunal flap transfer with multiple vascular pedicles for safe and reliable pharyngoesophageal reconstruction
Free jejunal flap transfer with multiple vascular pedicles for safe and reliable pharyngoesophageal reconstruction
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DOI：
10.1002/hed.25313
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发表时间：
2018-10-01
影响因子：
2.9
通讯作者：
Fujii, Takashi
中科院分区：
文献类型：
--
作者：
Kurita, Tomoyuki;Kubo, Tateki;Fujii, Takashi
在咽食管重建术中，我们移植了一个包含多个蒂的长空肠皮瓣，皮瓣成活率达到100%，并利用多余的肠系膜覆盖重要组织，填充死亡空间，减少手术部位感染、瘘形成等常见的术后并发症。方法结果回顾性分析243例多血管吻合空肠皮瓣转移术，观察皮瓣成活率、手术部位感染、瘘形成等术后早期并发症、围手术期死亡率、供区发病率。243个空肠皮瓣全部成活，无部分坏死。手术部位感染15例（6.2%），瘘管形成9例（3.7%）。围手术期死亡率为0.4%。供区发病7例（2.9%）。结论该方法虽需增加手术时间，增加血管吻合术，但操作安全可靠，成功率高。
BackgroundIn pharyngoesophageal reconstruction, we transferred a long jejunum flap containing multiple pedicles to achieve a 100% flap survival rate, and used the redundant mesentery to cover important tissues and fill in the dead space to reduce common postoperative complications, such as surgical site infections and fistula formation.MethodsResultsA total of 243 jejunal flap transfers with multiple vascular anastomoses were reviewed to examine flap survival and rates of early postoperative complications, such as surgical site infections and fistula formation, perioperative mortality, and donor site morbidity.All 243 jejunal flaps survived without any partial necrosis. The surgical site infections occurred in 15 cases (6.2%) and fistula formation in 9 cases (3.7%). The perioperative mortality rate was 0.4%. There were 7 cases (2.9%) with donor site morbidity.ConclusionAlthough our procedure requires extra operating time for additional vessel anastomoses, it could be performed safely and reliably with a high success rate.