静脈還流を別系統に行った遊離大網弁と遊離空腸移植の1例

抄録

 Free flap transfer is generally used in head and neck reconstruction surgeries, and many advantages of this procedure have been reported. The availability of reliable recipient vessels for free flap transfer may be limited in cases of prior neck dissection or radiation therapy. It is important that reconstruction is performed by safely using a vein graft or a bridge flap. Herein, we report a case in which venous return was performed using other vessels since the perfusion of the recipient vein was unsatisfactory.
 A 74-year-old man presented with recurrence of hypopharyngeal cancer. We performed reconstruction by using free jejunum transfer with an omental flap as a bridge flap. Although the omental flap collapsed because of necrosis, the artery survived, and since the veins were anastomosed to another variety, the jejunal flap distal to the bridge flap completely survived. It is necessary to choose a good recipient vessel from among the limited number of vessels that are functional after 2 or more operations, radiation therapy, or chemotherapy. We believe that perioperative evaluation is important when the condition of the recipient vessel is bad.