子宮頸部食道と喉頭の切除後の前縦隔気管切開の新しい方法：症例の報告

ここでは、気管壊死や気管壊死などの術後合併症の術後合併症を回避するために、食道癌の食道癌の拡張根治的手術時に胸膜筋皮皮脂肪の分割が適用された52歳の男性の症例を報告します。主要船の破裂。喉頭咽頭切除術と近位気管の拡大切除は、d菌摘出術を通じて行われ、気管の残骸はカリーナのわずか4 cm上に残りました。胸膜の主要な筋膜フラップを2つに分割し、1つのピースが前縦隔の気管切開部位の気管に巻き付けられ、もう1つは気管と腕下腸動脈の間に配置されています。術後の経過は平穏であり、患者は術後34日目に病院から退院しました。分裂胸筋筋皮フラップの主要な筋膜フラップは、気管と腕下腸動脈の間のデッドスペースを充填するだけでなく、気管皮膚吻合での緊張を軽減し、頭筋骨造体部位での循環損傷からの循環損傷を保護するのにも効果的です。

We report herein the case of a 52-year-old man for whom a split pectoralis major myocutaneous flap was applied at the time of extended radical surgery for esophageal carcinoma with tracheal involvement, to avoid the postoperative complications of anterior tracheostomy such as tracheal necrosis and rupture of the major vessels. Laryngopharyngectomy and extended resection of the proximal trachea was performed through a manubrectomy, leaving the tracheal remnant only 4 cm above the carina. A pectoralis major myocutaneous flap was split into two with one piece being wrapped around the trachea at the anterior mediastinal tracheostomy site, and the other being placed between the trachea and brachiocephalic artery. The postoperative course was uneventful and the patient was discharged from hospital on the 34th postoperative day. A split pectoralis major myocutaneous flap may be effective not only for filling the dead space between the trachea and brachiocephalic artery, but also for reducing tension at the tracheocutaneous anastomosis and protecting against circulatory damage at the mediastinal tracheostomy site to minimize stomal retraction.