広頸筋皮弁を用いて気管後壁の再建を行った頸部食道癌の1例

Reconstruction of Posterior Wall of Trachea in Esophageal Cancer by using Platysma Musculocutaneous Flap:Report of a Case

はじめに

　広頸筋皮弁は頬粘膜，歯肉，口腔底などの口腔内粘膜欠損部あるいは頸部の皮膚欠損部などの再建に用いられているが^1,2），われわれが調べた限りではこれを用いて気管後壁の再建を行ったという報告は未だみられない。

　一方，気管合併切除を要する頸部食道癌症例においては，気管断端を前胸部に縫着して永久気管孔を作成する必要があるため，複雑な手技が要求されることが多い。

Platysma musculocutaneous flap is usually used for reconstruction of the skin or full-thickness defects in the perioral area and midrace. The present paper reported reconstruction of the posterior tracheal wall after surgery for cervical esophageal cancer which involved the trachea.

A 66-year-old man underwent surgery for esophageal cancer in 1989. U-shaped skin incision was made 4 cm below the superior border of the sternum, and a platysma MC flap was elevated. After dissection of the neck and mediastinum and the extirpation of the hypopharynx, larynx, thy-roid esophagus and a part of the trachea, the esophagus was restored by use of colon, and the posterior defect of the trachea was reconstructed by use of the platysma MC flap. Postoperative course was uneventful, except for that the tracheal cannula was unable to remove.