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作者们简述了背阔肌皮瓣的有关解剖和手术原则并报告了用背阔肌皮瓣一期重建全咽和上颈部食管的一个病例。患者45岁女性,环后癌放疗、化疗后复发,右上颈深部可触到肿大淋巴结。采用改良MacFee切口(切口下端延长到肩峰)行全咽喉切除加右颈廓清及气管切开术。术前先标好背阔肌表面皮肤的范围14×8cm,其上界到肩胛下角,前界于背阔肌前缘后方约1.5cm。另从腋窝中点到皮岛上缘画一连线。沿背阔肌上画好的标志线切开皮肤,分离并掀起皮瓣。皮岛周围的肌肉要比皮缘多留1.5cm,以便围在做成的皮管外面以增加其强度。在血管进入肌皮瓣处的上方切断肌肉,其主要营养血管为胸背动、静脉,结扎它的小分枝
The authors outlined the anatomic and surgical principles of the latissimus dorsi flap and reported a case of a one-stage reconstruction of the entire pharyngeal and upper cervical esophagus with the latissimus dorsi flap. 45-year-old female patient, after ring cancer radiotherapy and chemotherapy, relapse after chemotherapy, the upper right neck deep palpable lymph nodes. The use of modified MacFee incision (incision extended to the acromion of the lower end of the line) and the right neck neck clearance and tracheotomy. Preoperative standard of the surface of the latissimus dorsi skin range 14 × 8cm, the upper bound to the underside of the scapula, the front of the latissimus dorsi about 1.5cm. Another from the midpoint of the armpit to the island edge painted a connection. Cut the skin along the marked line on the latissimus dorsi and separate and lift the flap. The skin around the skin island should stay 1.5cm more than the skin edge so as to surround the skinned tube to increase its strength. In the blood vessels into the muscle flap at the top of the cut off muscles, the main nutrient vessels for thoracodorsal, venous, ligation of its small branches