Abstract:
Objectives: We explored the value of supraclavicular flaps in repairing pharyngeal fistula. Methods: Patients treated with supraclavicular flaps were included. Data on preoperative radiotherapy, surgical modality, flap size, postoperative healing, and other clinical outcomes were collected. Techniques, indications, and postoperative complications after repairing with supraclavicular flaps were described. A total of 16 male patients aged 58 to 79 years were involved, including 10 cases of postoperative pharyngeal fistula after hypopharyngeal cancer, 5 cases of postoperative pharyngeal fistula after laryngeal cancer, and 1 case of postoperative pharyngeal fistula after laryngeal and esophageal cancer. In 12 patients, the pharyngeal fistula was repaired by double island folding of the supraclavicular flap; in the remaining 4 patients, the pharyngeal fistula was repaired by the supraclavicular flaps combined with the pectoralis major flaps. The supraclavicular flap was 6 to 8 cm in width and 6 to 15 cm in length. Results: One patient developed partial necrosis at the distal end of the flap, which was successfully treated with debridement and dressing. The flaps grew well in the remaining 15 patients. Among them, a patient with a postoperative pharyngeal fistula after hypopharyngeal carcinoma was implanted with radioactive particles for tumor recurrence at the esophageal entrance, and died in the 11th month after surgery. Conclusions: The supraclavicular flap can achieve excellent results in the repair of pharyngeal fistula.
摘要:
目的:探讨锁骨上皮瓣在咽瘘修复中的应用价值。方法:包括锁骨上皮瓣治疗的患者。术前放疗数据,手术方式,皮瓣尺寸,术后愈合,收集其他临床结局.技术,适应症,描述了锁骨上皮瓣修复后的并发症。共有16位年龄介乎58至79岁的男性病人参与,其中下咽癌术后咽瘘10例,喉癌术后咽瘘5例,喉癌、食管癌术后咽瘘1例。在12名患者中,通过锁骨上皮瓣双岛折叠修复咽瘘;在其余4例患者中,咽瘘采用锁骨上皮瓣结合胸大肌皮瓣修复。锁骨上皮瓣宽6~8cm,长6~15cm。结果:1例患者皮瓣远端出现部分坏死,通过清创和敷料成功治疗。其余15例患者的皮瓣生长良好。其中,一名下咽癌术后咽瘘患者在食管入口处植入放射性粒子治疗肿瘤复发,术后第11个月死亡.结论:锁骨上皮瓣修复咽瘘效果良好。