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頁籤選單縮合
題名 | New Era of Reconstructive Microsurgery=重建顯微手術的新紀元 |
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作者 | 陳宏基; | 書刊名 | 長庚醫學 |
卷期 | 20:3 1997.09[民86.09] |
頁次 | 頁153-162 |
分類號 | 416.45 |
關鍵詞 | 外科之進展; 自體組織移植; 顯微手術; 重建外科; 斷指再接; Advancement; Free flaps; Microsurgery; Reconstruction; Replantation; |
語文 | 英文(English) |
中文摘要 | 1903年Hopfner首先在動物實驗成功地完成肢體再植手術。而1962年Malt為上截肢 之病人完成斷肢再接。從此以後顯微重建手術就很快地進展,用於修補神經、血管及淋巴管 等手術中。從 1972 年開始,自體組織轉移也成功了。人體特定部位的組織可以藉血管吻合 的方法特移到其他需要的部位。 因此,這方法又延伸到以下的用途中:(1) 當傷口有骨、關 節、肌鍵及主要神經、血管裸露出來,而且無法用附近的組織轉過來覆蓋的話,就可以用游 離組織瓣加以重建。(2) 重要的骨骼有缺損,可以用帶有血管的骨頭加以重建。(3) 手關節 及顳頜關節亦可由足部關節轉移過來重建。(4) 上肢及臉部肌肉可以用其他功能性肌肉轉移 來重建。(5) 足趾可以轉到手部。(6) 腫瘤切除後之多元組織之重建。(7) 某些先天畸形之 重建。(8) 胸部、乳房、咽部及食道的重建。(9) 滑動組織、肋膜及帶有神經感覺的皮瓣之 轉移。未來重建顯微手術是朝著精緻化,提升功能及外觀並減少供應區缺損的方向在進展。 由於顯微器械及縫線的進步,加上電腦和影像科技學的發展,外科醫師可藉以做更精密的手 術。內視鏡被用於供應區來取組織瓣。畸形的重建手術也將被用於小關節的手術。此外顯微 手術如將配合義肢以改良義肢的功能。顯微關節鏡也將用於小關節的手術,顯微手術又可以 改良血管外科及腫瘤切除的結果。結論是顯微重建未來勢必會持續進展以邁向完美之境界。 |
英文摘要 | Hopfner performed the first successful experimental limb replantation in 1903, and Malt performed the first successful clinical replantation for an above - elbow amputation in 1962. Since then the range of applications for reconstructive micro- surgery has expanded rapidly, and it is now widely used for repair of nerves, vessels and lymphatics. In 1972 the first successful case of free flap transfer was performed. Many new applications followed including: (1) coverage of extensive wound defects with exposure of bones, joints, tendons and major vessels which can not be covered with local tissue; (2) vascularized bone transfer for bone defects; (3) vascularized joint transfer for hand joints and the temporomandibular joints; (4) functioning muscle transfer to replace the muscles of the upper limbs and face; (5) toe transfer for missing fingers and thumbs; (6) reconstruction following tumor ablation; (7) reconstruction of congenital anomalies; (8) reconstruction of chest, pharynx and cervical esophagus; (9) transfer of gliding tis- sue, fascia and sensory flaps for certain injuries. The goals of future reconstructive microsurgery include refinement of procedures, enhancement of functional and aesthetic results, and minimization of the morbidity of donor sites. Improvements of instruments, sutures and computer imaging systems will enable surgeons to perform more accurate reconstructions. Endoscopic harvesting of flaps will be widely used. Surgery will be performed on newborns with certain congen- ital anomalies. Microsurgery will be increasingly used in conjunction with a prosthesis to improve the function of the prosthesis. Microarthroscopy will be used in operations involving small joints. Advances in microsurgery techniques may also change the results of vascular surgery and tumor resection. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。