纵隔镜食管切除术中的气管损伤是一种危及生命的并发症,具有挑战性。然而,尚未定义精确的治疗方法。一名80岁的男性上食管癌患者接受了纵隔镜食管切除术和后纵隔途径胃管重建。当使用双极血管密封系统将食管与气管分离时,膜状气管的左侧在胸骨切迹以下7厘米处出现了3厘米的缺损。我们成功地修复了气管损伤,而不是通过直接缝合缺损,而是通过带蒂胸锁乳突肌皮瓣加强它。将胃管放置在气管修补术上,通过后纵隔途径进行食管重建。因此,病人恢复良好并出院。胸锁乳突肌皮瓣可能是气管损伤中加固皮瓣的另一种手术选择。
Tracheal injury during mediastinoscopic esophagectomy is a life-threatening complication that is challenging to manage. However, no precise treatment has been defined. An 80-year-old male patient with upper esophageal cancer underwent a mediastinoscopic esophagectomy and gastric tube reconstruction through the posterior mediastinal route. When the esophagus was separated from the trachea using a bipolar vessel sealing system, the left side of the membranous trachea incurred a 3-cm defect 7 cm below the sternal notch. We successfully repaired the tracheal injury not by directly suturing the defect but by reinforcing it with a pedicle sternocleidomastoid flap. The gastric tube was placed over the tracheal repair for esophageal reconstruction via a posterior mediastinal route. As a result, the patient recovered well and was discharged. A sternocleidomastoid flap might be another surgical option for reinforcement flaps in tracheal injuries.