各種前胸壁有茎皮弁による再建食道管腔のX線学的・内視鏡的観察

抄録

Radiological and fiberendoscopical observations of the cervical esophagus reconstructed by such three kinds of pedicled anterior chest flap techniques as DP flap, pectoral island skin flap and pectoralis major myocutaneous island flap (PMMCF) were discussed on six clinical cases which have been surviving from one and a half years to 8 years postoperatively.
From esophagographical findings, pectoral island skin flap was proved to be most smooth in shape at the lower anastomosis and new esophagus of PMMCF tended to bend at the lower anastomosis with the pedicle of pectoralis major muscle. A larger space of tubed esophagus of the skin flap arose a relative stenosis at the lower mucocutaneous junction to the esophagus.
By fiberendoscopical observations, the surface of the reconstructed cervical esophagus showed no difference in all kinds of skin flaps, although the cases with shorter period of reconstruction had more debris and drainings. Suture knotches, therefore, should be buried in the tissue to prevent micro abcesses around them.
It is also necessary for us head and neck surgeons to take preventive measures against scared stenosis, dead space, infection, fistula formation and tension around the mucocutaneous junction.