微小血管吻合による頭頸部癌摘出後の再建

概要

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Microvascular reconstruction has become a reliable procedure after the ablation of oral or pharyngeal cancer.<BR>Seven pat i e nts underwent reconstruction of the hypopharyngeal and cervical esophageal cancer by use of free jejunal graft techniques in our clinic. All patients could begin to drink and eat in 2 weeks after operation. With this method, wide resection of hypopharynx and cervical esophagus was possible. In one case, radical wide resection with mediastinal dissection was accomplished using free jujunum transfer.<BR>Radial forearm flap was preferable as a patch for reconstru c tion of defects of oral cavity and mesopharynx.<BR>We performed reconstruction of oral cavity or mesopharynx with 7 radial forearm flaps and one free rectus abdominis musculocutaneous flap in eight patients. All forearm flaps were successful, but the rectus abdominis flap became ischemic on the next day. The immediate reoperation revealed that the cause of ischemia was venous thrombosis, and reanastomosis of the vein with vein interposition could make the flap survive without oral fistula or necrosis.<BR>In conclusion, microvascular reconstruction is clearly beneficial for head and neck cancer.
耳鼻咽喉科臨床学会の論文