锁骨上岛状皮瓣在下咽及食管上段恶性肿瘤手术修复中的应用  

Clinical application of supraclavicular flap for oncologic reconstruction of hypopharynx and upper esophagus

作　　者：文译辉[1] 文卫平[1] 王章锋[1] 祝小林[1] 蒋爱云[1] 柴丽萍[1] 雷文斌[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院 广州市耳鼻咽喉科重点实验室,广州510080

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第1期16-20,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：广东省科技计划项目（20170506018）;广东省自然科学基金（2015A030310236、2016A030313247、2017A030310362）

摘　　要：目的探索锁骨上岛状皮瓣在修复下咽及食管上段恶性肿瘤术后缺损中的临床应用。方法回顾性分析2015年12月至2017年6月中山大学附属第一医院耳鼻咽喉科医院应用带蒂锁骨上岛状皮瓣修复头颈部肿瘤手术缺损10例患者的病例资料，其中下咽癌食管上段缺损修复8例，下咽平滑肌肉瘤咽后壁缺损修复1例，颈部皮肤缺损修复1例。取锁骨上岛状皮瓣修复缺损（无需血管吻合），皮瓣面积（4～8）cm×（5～12）cm。记录皮瓣切取时间，皮瓣存活情况及供区情况。结果10例锁骨上岛状皮瓣切取时间20～30 min，平均26 min。10例患者中9例皮瓣全部存活，1例皮瓣发生部分坏死合并咽瘘。供区缺损均直接拉拢缝合，无伤口感染及功能损伤等并发症。结论锁骨上岛状皮瓣具有制备技术简单，修复缺损可靠，美观，无局部功能损伤，无需显微血管吻合等优点，可用于下咽及食管上段恶性肿瘤术后的缺损修复。ObjectiveTo assess the efficacy of supraclavicular artery island flap （SCAIF） for the reconstruction of hypopharynx and upper esophagus.MethodsThe SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in （4-8） cm×（5-12） cm. Clinical indexes such as harvesting time and survival were recorded.ResultsHarvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications.ConclusionsSCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.

关 键 词：外科皮瓣 头颈部肿瘤 修复外科 

分 类 号：R739.91[医药卫生—肿瘤]