ｍｉｃｒｏｖａｓｃｕｌａｒ ｓｕｒｇｅｒｙによる頭頚部癌摘出後の再建

Abstract

Microvascular tissue transfer is recommended by plastic surgeons for defects following radical ablation of head and neck tumors. After experimenting with microvascular anastomosis of the femoral vessels of guinea pigs, we performed reconstruction of head and neck defects following radical surgery for six oral and hypopharynx cancer with three free jejunums, three forearm flaps and one free latissimus dorsi myocutaneous flap.Radial forearm flaps are very suitable for intraoral reconstruction because of their pliability, thin, hairless skin and long vessel pedicles. Even in patients who had had high doses of irradiation or several cervical operations, the forearm flaps were useful and successful.Free jejunum transfer was very effective for hypopharyngeal cancer, since wide resection of the cervical esophagus and hypopharynx was possible. Two of our three patients had no complication after the operation. One patient had a small fistula at the pharyngo jejuno junction, but it healed spontaneously within two weeks. The average time from the operation to the beginning of oral feeding was ten days in our three patients.We consider that microvascular tissue transfer is preferable and useful following surgery for head and neck cancer.