锁骨上岛状皮瓣在气管缺损修复中的应用分析  

Clinical application of supraclavicular fasciocutaneous island flap in the repair of tracheal defects

作　　者：赵佳正 郭良 楼建林 谭向荣 郑文 全华涛 潘超 Zhao Jiazheng;Guo Liang;Lou Jianlin;Tan Xiangrong;Zheng Wen;Quan Huatao;Pan Chao(Department of Head and Neck Surgery,Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Cancer and Basic Medicine(IBMC),Chinese Academy of Sciences,Zhejiang Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province,Hangzhou 310022,China;Department of Thoracic Surgery,Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Cancer and Basic Medicine(IBMC),Chinese Academy of Sciences,Hangzhou 310022,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)头颈外科,中国科学院肿瘤与基础医学研究所,浙江省头颈肿瘤转化医学研究重点实验室,杭州310022 [2]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)胸部外科,中国科学院肿瘤与基础医学研究所,杭州310022

出　　处：《中华耳鼻咽喉头颈外科杂志》2021年第9期925-929,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探索锁骨上岛状皮瓣(supraclavicular fasciocutaneous island flap,SIF)在气管缺损修复中的临床应用。方法回顾性分析2016年5月至2021年3月,中国科学院大学附属肿瘤医院头颈外科及胸部外科应用SIF修复颈胸部肿瘤手术后气管缺损的10例患者的临床资料,男性8例,女性2例,年龄27~73岁。其中喉气管腺样囊性癌2例,喉鳞癌2例,食管鳞癌3例,甲状腺乳头状癌2例,甲状旁腺腺癌1例;原发肿瘤均为T4期。分析10例SIF修复气管缺损的效果。结果设计SIF,皮瓣面积(3~7)cm×(6~10)cm,皮瓣厚度8~11 mm,蒂部长度10~15 cm,10例皮瓣血供均来自颈横动脉,肩部供区皮肤缺损均直接拉拢缝合关闭。术后随访1~60个月,皮瓣全部存活,皮瓣与气管愈合佳,肩部切口愈合可。结论SIF修复气管缺损厚度合适,制取技术简单,不需要显微外科技术,有较好的应用前景。Objective To explore the clinical application of supraclavicular fasciocutaneous island flap(SIF)in the repair of tracheal defect.Methods From May 2016 to March 2021,the clinical data of 10 patients(8 males,2 females,aged 27-73 years old)were retrospectively analyzed who underwent repair surgery with SIF for trachea defects after resection of cervical or thoracic tumors,including 2 cases of laryngotracheal adenoid cystic carcinoma,2 cases of laryngeal carcinoma,3 cases of esophageal carcinoma,2 cases of thyroid carcinoma and one case of parathyroid carcinoma.All of the primary tumors were at T4.The outcomes of 10 cases with tracheal defect repaired by SIF were evaluated.Results The areas of the SIF were(3-7)cm×(6-10)cm,the thicknesses of the flaps were 8-11 mm,and the lengths of the pedicles were 10-15 cm.The blood supply of the SIF came from the transverse carotid artery.The skin defects of the donor areas of the shoulders were directly closed.After 1-60 months of follow-up,all the flaps survived.The flaps,tracheas as well as shoulder wounds healed well.Conclusion The SIF is suitable for the repair of tracheal defects.It has perfect thickness compatible with the trachea.The technique is simple and microsurgical technique is not needed,with a good application prospect.

关 键 词：外科皮瓣 修复外科手术 气管缺损 

分 类 号：R653[医药卫生—外科学]