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Externalized Mesentery Monitoring of Vascularized Jejunum Transfers

Arata, Jun 京都大学 DOI:10.14989/doctor.r13383

2021.01.25

概要

Purpose
The use of externalized jejunal monitoring flaps for jejunum transfers could be facilitative for the direct clinical assessment. Though this monitoring method would seemed to be highly reliable, we modified this method and used mesentery only as a monitor to make it easy to manage the monitor more.

Materials and Methods
Between 2013 and 2018, 43 patients underwent vascularized jejunum transfer for reconstruction of laryngopharyngectomy using the externalized mesentery monitor. There were 39 men and 4 women and patient ages ranged from 40 to 80 years, (average 66.6 years). The nursing staff monitored the externalized mesentery by using handheld Doppler ultrasonography every 2 hours for 7 days after surgery.

Results:
3 patients had rather weak signal of handheld Doppler ultrasonography on the externalized mesentery monitors during operation and could not be applied handled Doppler ultrasonography. Of the remaining 40 patients using the externalized mesentery monitor with handled Doppler ultrasonography, 39 had an uncomplicated postoperative period. In one patient, no signal of Doppler ultrasonography and lack of bleeding by pin prick from the monitor segment were noted in the immediate postoperative period and revision of the vascular anastomosis was performed. Finally the graft was salvaged. There was no case of infection in the monitoring flap or hypertrophic scar at the part resected the flap.

Conclusions:
Using the externalized mesentery monitoring flaps, clinical monitoring by examining the exteriorized monitoring flap is possible. And only mesentery monitors were managed easily than jejunum monitoring flaps.

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参考文献

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