Advantages of a latissimus dorsi muscle flap to close a gastric tube-to-tracheal fistula and prevent tracheobronchial complications after salvage surgery for esophageal cancer: report of three cases

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• 作者：Kiyotomi Maruyama ; Kou Shimada ; Mitsutoshi Abe ; Shinsuke Sugenoya…
• 关键词：Esophagectomy ; Esophageal cancer ; Fistula ; Trachea ; Latissimus dorsi muscle
• 刊名：Esophagus
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：13
• 期：2
• 页码：220-228
• 全文大小：1,136 KB
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• 作者单位：Kiyotomi Maruyama (1)
  Kou Shimada (1)
  Mitsutoshi Abe (1)
  Shinsuke Sugenoya (1)
  Yoshiaki Ikeda (1)
  Yuta Yamamoto (1)
  Kuniyuki Gomi (1)
  Kazutoshi Hamanaka (1)
  Motohiro Mihara (1)
  Shoji Kajikawa (1)
  
  1. Department of Surgery, Suwa Red Cross Hospital, 5-11-50, Kogandoori, Suwa, Nagano, 392-0027, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Pathology
  Thoracic Surgery
  Surgical Oncology
  Oncology
  
• 出版者：Springer Japan
• ISSN：1612-9067

文摘

Tracheobronchial fistulae after esophagectomy are rare but critical complications because they frequently cause severe pneumonia. In three cases with esophageal cancer, we used the latissimus dorsi muscle after esophagectomy to reinforce the fragile tracheobronchus. In cases 1 and 2 with gastric tube-to-tracheal fistula, the gastric tube was pulled out from the posterior mediastinum, the fistula was excised, and the trachea was covered with the pedicle latissimus dorsi muscle flap followed by reconstruction of the digestive conduit by the subcutaneous route. Case 3 had relapsed esophageal cancer after definitive chemoradiotherapy for T4 (trachea) esophageal cancer; we performed salvage surgery and covered the fragile tracheobronchus using the muscle. Various muscles have been used as reinforcement for the tracheobronchus. The latissimus dorsi muscle is especially useful to reinforce tissue with extensive lesions from the upper trachea to the bilateral bronchi because of this large and highly vascularised tissue.