颈阔肌皮瓣修复颈段食管狭窄的疗效观察  

The effect of platysma myocutaneous flaps repairing stenosis of cervical esophagus

作　　者：龚太乾[1] 王如文[1] 蒋耀光[1] 赵云平[1] 周景海[1] 谭群友[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军胸外科中心,重庆400042

出　　处：《中华胸心血管外科杂志》2002年第5期290-291,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　探讨颈阔肌皮瓣修复颈段食管狭窄的疗效。方法　回顾分析 1990年 4月至 2 0 0 1年 7月 ,采用单侧颈阔肌皮瓣修复颈段食管狭窄 2 3例的近期及远期效果。结果　全组无手术死亡 ,肌皮瓣全部成活。 3例发生吻合口瘘 ,更换敷料后愈合。术后随访 6～ 136个月。 2例术后 4个月和 6个月发生吻合口狭窄 ,分别经扩张和再次手术修复治愈 ;所有病人均能正常经口进普食。纤维食管镜检查示肌皮瓣无糜烂、溃疡及癌变。结论　颈阔肌皮瓣修复颈段食管狭窄 ,具有创伤小 ,转移就近、方便 ,能一期完成手术 ,并发症少 ,远期疗效好等优点 ,临床上值得推广应用。Objective: To observe the effect of platysma myocutaneous flaps (PMF) for repairing the stenosis of cervical esophagus. Methods: Retrospective analysis was carried out in 23 patients with stenosis of the cervical esophagus repaired by PMFs in our department from April 1990 to July 2001. The patients were followed up for 6 to 136 months with esophagography and esophagoscopy. The pathological changes of the flaps were examined with biopsy in 4 cases. Results: There was no operative death. All the flaps survived. Three patients developed fistula of cervical anastomosis after operation and healed with conservative method. Stricture of cervical anastomosis occurred in 2 cases, one patient received dilatation and one treated by reoperation. The transferred flaps had no ulcer and cancer in ling time follow up. The squmaous epithelial lawyer of the skin is thinner, but keeps keratinization. All the patients were able to take solid foods. Conclusion: The advantages of repairing stricture of cervical esophagus with PMF is that the operative wound is small, the transference is easy and can be completed in one stage, the postoperative complication is low, the long term result is excellent. The PMF is one of good options for cervical esophageal repair.

关 键 词：颈阔肌皮瓣 疗效 食管狭窄 食管成形术 外科皮瓣 

分 类 号：R655.4[医药卫生—外科学]