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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Early prediction of anastomotic leakage after free jejunal flap reconstruction of circumferential pharyngeal defects
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Early prediction of anastomotic leakage after free jejunal flap reconstruction of circumferential pharyngeal defects

机译：空肠空位瓣重建周围咽部缺损后吻合口漏的早期预测

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Background: Anastomotic leakage from the free jejunal flap, if diagnosed late, can result in catastrophes. Our study aims to look for clinical parameters that allow early identification of leakage so that appropriate interventions can be taken. Method: Between 1980 and 2011, consecutive patients with free jejunal flap reconstruction of circumferential pharyngeal defects were included. A retrospective chart review was then performed comparing the clinical parameters (body temperature, heart rate, serum albumin, haemoglobin and white cell count) between patients with no leakage and those with clinical and radiological leakage. Level of evidence: 4. Results: Ninety-six patients were included in the study. The median age was 62 years. Majority (69.8%) of the defects were created after resection of tumours in the hypopharynx. Five (5.2%) patients had clinical leakage and 12 (12.5%) had radiological leakage. There was no significant difference in body temperature, heart rate, incidence of atrial fibrillation and haemoglobin level between those with and without leakage. The serum white cell count was higher in the patients who leaked, but it became statistically significant only after day 7 postoperatively. The serum albumin level was significantly lower in patients with anastomotic leakage starting as early as day 3 after surgery, and the difference persisted until the leak was controlled. However, there was no significant difference in the plasma albumin level between those with clinical or radiological leak. Conclusion: Both serum albumin level and white cell count identified the presence of anastomotic leakage from the free jejunal flap. Serum albumin allows early prediction of leakage so that early interventions can be taken to avoid the damage resulting from the delay in diagnosis. ? 2012 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
机译：背景：空肠游离皮瓣的吻合口漏出，如果诊断较晚，可能会导致灾难。我们的研究旨在寻找可及早发现渗漏的临床参数，以便采取适当的干预措施。方法：在1980年至2011年之间，包括连续性空肠游离皮瓣再造的周围性咽部缺损患者。然后进行回顾性图表审查，比较无渗漏患者与临床和放射学渗漏患者之间的临床参数（体温，心率，血清白蛋白，血红蛋白和白细胞计数）。证据水平：4.结果：96名患者被纳入研究。中位年龄为62岁。大部分（69.8％）的缺陷是在下咽部肿瘤切除后形成的。 5名（5.2％）患者出现临床渗漏，而12名（12.5％）患者出现放射渗漏。有无渗漏者的体温，心率，心房纤颤发生率和血红蛋白水平无显着差异。渗漏患者的血清白细胞计数较高，但仅在术后第7天才具有统计学意义。最早在手术后第3天开始，患有吻合口漏的患者的血清白蛋白水平显着降低，并且这种差异一直持续到控制漏口为止。但是，有临床或放射学渗漏者之间血浆白蛋白水平无显着差异。结论：血清白蛋白水平和白细胞计数均可确定空肠游离皮瓣吻合口漏的存在。血清白蛋白可以及早预测渗漏，因此可以尽早采取干预措施，以避免因诊断延迟而造成的损害。 ？ 2012年由Elsevier Ltd代表英国整形，修复和美学外科医生协会出版。版权所有。

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