Pharyngoesophageal Reconstruction with A Tubed Radial Forearm Free Flap: A Case Report.

IF 0.9 Q3 SURGERY
Lugo Beltran Ignacio, Guitian González Marisol, Ornelas-Flores María Cristina, Uribe Briceño David Armando, Delcid Morazán Allan Fernando
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Abstract

Hypopharyngeal carcinoma is one of the most aggressive primary head and neck cancers, often managed through partial or total laryngopharyngectomy. Reconstruction after such surgeries remains a challenging procedure that often requires the use of free flaps. A 63-year-old male patient with in-situ squamous cell carcinoma of the left vocal cord treated with total pharyngolaryngectomy and primary reconstruction with a left radial forearm free flap, complicated by flap necrosis, which ended up in dismantling and gastrostomy. He was referred to the Plastic and Reconstructive Surgery Department at Centro Medico Nacional 20 de Noviembre, Mexico in 2023 to assess the reconstructive options for the hypopharynx and cervical esophagus defect. A tubular right radial forearm free flap was designed forming the anterior wall of the hypopharynx and cervical esophagus and a posterior wall for the external defect. Twelve months after his surgery, he continues tolerating oral intake without signs of stenosis or tumor recurrence. The objective in this case was based on restoring the continuity of the digestive tract and swallowing function, as well as providing skin coverage of the defects, and preventing serious complications. The radial forearm free flap has versatility in the tubular construction and a low leak rate, as well as an adequate skin island size. Conclusion: The pharyngoesophageal reconstruction with a tubed forearm free flap has favorable outcomes for restoring the gastrointestinal tract without further complications.

用带管前臂桡侧游离皮瓣重建咽食管:病例报告
下咽癌是侵袭性最强的原发性头颈部癌症之一,通常通过喉咽部分或全部切除术来治疗。此类手术后的重建仍然是一项具有挑战性的手术,通常需要使用游离皮瓣。一名 63 岁的男性患者患有左声带原位鳞状细胞癌,接受了全喉切除术,并使用左桡前臂游离皮瓣进行了初次重建,但术后皮瓣坏死,最终导致手术失败并进行了胃造瘘术。2023 年,他被转诊到墨西哥新月 20 日国立医疗中心整形外科,以评估下咽和颈部食道缺损的重建方案。他设计了一个管状右桡前臂游离皮瓣,形成下咽和颈部食道的前壁,后壁用于外部缺损。手术 12 个月后,他仍能继续进食,没有出现狭窄或肿瘤复发的迹象。该病例的目标是恢复消化道的连续性和吞咽功能,同时为缺损部位提供皮肤覆盖,并预防严重并发症。前臂桡侧游离皮瓣具有管状结构的多功能性、低渗漏率以及足够的皮肤岛大小。结论使用管状前臂游离皮瓣进行咽喉食管重建,在恢复胃肠道功能方面效果良好,且不会出现更多并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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11.10%
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