Upotreba režnja pectoralis major za zatvaranje faringokutane fistule posle totalne laringektomije – dva različita pristupa
Sažetak
Uvod. Rekonstrukcija velikih postoperativnih defekata posle onkološke hirurgije glave i vrata i dalje predstavlja veliki izazov. Regionalni režnjevi smatraju se prihvatljivijom rekonstruktivnom opcijom u poređenju sa slobodnim režnjevima. Pectoralis major režanj je jedna od najčešće primenjivanih opcija u rekonstrukciji velikih defekata glave i vrata. Prikaz bolesnika. Prikazujemo ključne tačke u hirurškoj tehnici podizanja pectoralis major režnja kod dva bolesnika lečena u jednom od univerzitetskih centara tercijarne medicinske zaštite. Oba bolesnika, prosečne starosti 64 godine, bila su muškog pola. Defekti koji su zahtevali rekonstrukciju nalazili su se kod prvog prikazanog bolesnika na bočnoj strani vrata, a kod drugog bolesnika na prednjoj strani vrata. Režnjevi su korišćeni za pokrivanje faringokutane fistule nastale posle totalne laringektomije i zračne terapije. Donorsko mesto je zatvarano primarno. Kod oba bolesnika režnjevi su zarasli primarno i bez komplikacija. Zaključak. Pectoralis major režanj ima postojanu vaskularnu peteljku i može biti uspešno iskorišćen za rekonstrukciju velikih defekata glave i vrata. Da bi režanj preživeo, operativna tehnika mora biti besprekorna.
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