日本語フィールド
著者：*畑山 絵理子, 鈴木 久美子, 與田 幸恵, 上村 哲司, 倉富 勇一郎題名：症例 下咽頭癌に対する根治治療6年後に発症し大胸筋皮弁により閉鎖できた気管食道瘻の1例発表情報：頭頸部外科 巻: 31 号: 1 ページ: 57 - 63キーワード：気管食道瘻, 下咽頭癌, 化学放射線療法, 大胸筋皮弁, 有害事象概要：下咽頭癌に対する根治治療から6 年後に発症し，大胸筋皮弁を用いた頸部手術で閉鎖できた気管食道瘻の1例を経験したので報告する。症例は59歳男性。下咽頭癌に対して化学放射線療法および咽喉頭全摘術・両側頸部郭清術・遊離空腸再建術を施行し，再発はなかったが，6年後に気管後壁から頸部食道に直径5mmの気管食道瘻を認めた。食道と気管を剥離し，食道欠損部を横縫合し，その上に筋体が食道側と気管側の間に介在するように大胸筋皮弁を置いて気管後壁を再建し，瘻孔を閉鎖した。本症例の気管食道瘻は主に化学放射線療法・根治手術後の血流障害に起因すると考えられ，その閉鎖には血流豊富な大胸筋皮弁が有用であった。抄録：英語フィールド
Author：*Eriko Hatayama, Kumiko Suzuki, Yukie Yoda, Tetsuji Uemura, Yuichiro KuratomiTitle：Successful repair by using pectralis major myocutanous flap for the tracheoesophageal fistula developing 6 years after the curative treatment for hypopharyngeal carcinoma: A case reportAnnouncement information:JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY Vol: 31 Issue: 1 Page: 57 - 63Keyword：tracheoesophageal fistula, hypopharyngeal carcinoma, chemoradiotherapy, pectoralis major myocutaneous flap, complicationAn abstract：We report a rare case of tracheoesophageal fistula which developed 6 years after curative treatment for hypopharyngeal carcinoma and which was successfully repaired by using a pectoralis major myocutaneous flap. A 59-year-old man underwent chemoradiotherapy followed by pharyngolaryngectomy with bilateral neck dissection and free jejunum flap reconstruction. No recurrence was observed after the curative treatment, however, a tracheoesophageal fistula with a diameter of 5mm was detected in the posterior tracheal wall 6 years after the treatment. Surgical repair of the tracheoesophageal fistula was performed, consisting of division of the fistula, transverse suture of the esophagus, covering the esophageal suture by a pectoralis major myocutaneous flap, and reconstruction of the tracheal defect with the skin of the flap. The postoperative course was favorable. It was considered that the tracheoesophageal fistula of this patient was caused by poor blood circulation after the chemoradiotherapy and surgery. Pectoralis major myocutaneous flap with abundant blood circulation was useful as an interposed flap for reliable repair of the tracheoesophageal fistula.