フクナガ　ユタカ   Yutaka Fukunaga   福永　豊    所属   川崎医科大学  医学部 臨床医学　形成外科学    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Stripped Mesenteric Flap: A Novel Option for Preventing Anastomotic Leakage in Circumferential Pharyngeal Reconstruction.
掲載誌名	正式名：Plastic and reconstructive surgery. Global open 略　 称：Plast Reconstr Surg Glob Open ISSNコード：21697574/21697574
掲載区分	国外
巻・号・頁	6(11),pp.e2014
著者・共著者	Yutaka Fukunaga, Takuya Higashino, Azusa Oshima, Ryuichi Hayashi
発行年月	2018/11
概要	Reconstruction of a circumferential pharyngeal defect with a free jejunal flap is a well-established procedure. However, anastomotic leakage often occurs, which can lead to abscess formation, pharyngocutaneous fistula formation, and carotid rupture. Previous reports have described covering the anastomotic site with a mesenteric flap to prevent anastomotic leakage. However, the mesentery is covered by a serosal membrane, which interferes with adhesion and vascular communication. Therefore, we stripped off the serosal membrane to accelerate adhesion to the anastomotic site. We retrospectively studied patients who had a history of radiotherapy and who had received a stripped mesenteric flap in a circumferential pharyngeal reconstruction procedure. We collected the following data: operative time, blood loss, postoperative complications, interval to resumption of oral intake, and duration of hospital stay. We obtained data for 11 patients. The jejunal flap failed in one patient because of arterial thrombosis. One of the other 10 patients developed anastomotic leakage caused by congested mucous membrane necrosis. The patient was treated conservatively and showed no clinical symptoms of infection or inflammation. The 9 remaining patients had no anastomotic leakage. In the present series, although anastomotic leakage was observed in one of 10 patients who underwent circumferential pharyngeal reconstruction using a stripped mesenteric flap, the severity of the leakage was minimized.
DOI	10.1097/GOX.0000000000002014
PMID	30881805