基于患者和缺损选择的前外侧大腿皮瓣与游离空肠移植在环周咽食管重建中的比较
Comparison of Anterolateral Thigh Flap and Free Jejunal Transfer Based on Patient- and Defect-Based Selection for Circumferential Pharyngoesophageal Reconstruction.
文献信息
| PMID | 42730494 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kaho Momiyama |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan. |
| 期刊 | Head & neck |
| SCI 分区 | Q1 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 本研究比较了咽喉食管切除术后前外侧大腿（ALT）皮瓣与游离空肠移植（FJ）重建的手术和功能结局。
方法： 我们回顾性分析了53例接受咽喉食管切除术并即刻重建的患者：33例采用ALT，20例采用FJ。比较了手术和功能结局以及术后CT表现。
结果： FJ优先选择用于需要深部食管吻合的向尾侧延伸缺损，而ALT主要用于颅侧缺损。手术结局、饮食状况和住院时间相当。吻合口狭窄发生于1例ALT患者（3%）和2例FJ患者（10%）。在CT上，ALT管道更常位于气管外侧（70%对45%），饮食状况相当。ALT的语音获得率更高。
结论： 基于患者和缺损的选择实现了相当的结局和较低的狭窄率。ALT是特定患者免开腹的选择，而对于需要深部纵隔吻合的向尾侧延伸缺损，FJ可能更可取。
英文摘要
BACKGROUND: This study compared surgical and functional outcomes between anterolateral thigh (ALT) flap and free jejunal transfer (FJ) reconstruction after pharyngolaryngoesophagectomy.
METHODS: We retrospectively reviewed 53 patients undergoing pharyngolaryngoesophagectomy with immediate reconstruction: 33 with ALT and 20 with FJ. Surgical and functional outcomes and postoperative CT findings were compared.
RESULTS: FJ was preferentially selected for caudally extended defects requiring deep esophageal anastomosis, whereas ALT was mainly used for cranial defects. Surgical outcomes, dietary status, and hospital stay were comparable. Anastomotic stricture occurred in 1 ALT patient (3%) and 2 FJ patients (10%). ALT conduits were more frequently lateral to the trachea on CT (70% vs. 45%), with comparable dietary status. Speech acquisition was higher with ALT.
CONCLUSIONS: Patient- and defect-based selection achieved comparable outcomes with low stricture rates. ALT is a laparotomy-free option for selected patients, whereas FJ may be preferable for caudally extended defects requiring deep mediastinal anastomosis.