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| 題 名 | Prefabricated Tensor Fascia Lata Myocutaneous Flap for Total Esophageal Reconstruction--A Case Report=預鑄張肌闊筋膜皮瓣行食道重建 |
|---|---|
| 作 者 | 張高榮; 陳宏基; 吳怡成; 魏福全; 侯勝博; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 32:3 民88.05-06 |
| 頁 次 | 頁125-129 |
| 分類號 | 416.241 |
| 關鍵詞 | 預鑄張肌闊筋膜皮瓣; 食道重建; Prefabricated tensor fascia lata myocutaneous flap; Esophageal reconstruction; |
| 語 文 | 英文(English) |
| 中文摘要 | 用來重建整段食道的選擇中,胃和大腸是列為第一優先考慮的,而空腸是第二的選擇。然而在有些情況下,以上的臟器皆無法使用,筋皮及肌皮自由皮瓣便提供了另一種的選擇。預先鑄好的張肌闊筋膜皮瓣就是其中之一,且提供足夠的長度和更可靠的重建方法。在1996年,我們用此方法來重建一個病人的整段食道。在第一階段手術時,先把此皮瓣前後翻起,原地預鑄成管狀。三個星期後,第二階段手術將預鑄的皮瓣藉著顯微手術移轉至頸部,且埋在皮下。三個月後,第三階段手術將空腸自腹部經皮下,與皮瓣下端縫合。病人預後良好。雖然預鑄張肌闊筋膜皮瓣不是重建整段食道的第一選擇,但不失做為一種備用的好方法。 |
| 英文摘要 | For the reconstruction of a long segment or total defect of the esophagus, the stomach and colon are the fnrst choices among the substitutes, and the jejunum follows. In case of limited use of all intraabdominal viscuses, the free fasciocutaneous and myocutaneous flaps provide another choice. The prefabricated tensor fascia lata myocutaneous flap can provide a longer and more secure substitute. One patient who needed reconstruction of the entire esophagus due to corrosive injury in 1996 was presented. The stomach, colon and jejunum were not available because of previous intraabdominal operations. The extended tensor fascia lata flap was elevated anteriorly and posteriorly, and rolled into a tubular form with skin inside in the first stage. In the second stage, the microsurgical transfer of the prefabricated flap to reconstruct the esophagus in the neck via the subcutaneous tunnel was performed. In the third stage, the lower end of the flap was joined to the jejunum in Roux-en-Y fashion. The patient started oral diet one month after reconstruction. The follow-up esophagogram revealed a good patency. Although the prefabricated tensor fascia lata flap would not be a procedure of first choice, it is a worthwhile backup operation in esophageal reconstruction. |
本系統中英文摘要資訊取自各篇刊載內容。