Application Of Intercostal Mscile Flap In The Surgery Of Esophageal Foreign Body

Esophageal foreign bodies is a common clinical emergency, usually caused by the accidental swallowing. Most of them can be removed by esophagoscopy, but a very small part of the esophageal foreign bodies impact in the esophagus, causing the esophageal wall avascular necrosis, inflammation, ulceration and even perforation,possibly combined by trancheoesophageal fistula oraortic esophageal fistula or other dangerous complications.And addtion,esophageal fistula prone to happen after repairing.Further,some patients need a second surgery, imposing tremendous physical and psychological suffering to patients,greatly increasing the patient's financial burden.How to prevent the maximum possible reduction in the incidence of postoperative esophageal fistula is a challengea faced by thoracic surgeon.Simple esophageal repair can not effectively prevent the occurrence of postoperative esophageal fistula for patients whose esophagus have been a serious local inflammatory edema and even perforation.There is information indicating that sorrounding tissue with vascular is effective in promoting the esophagus healing and reducing the incidence of postoperative fistula.Pedicled intercostal muscle flap is the ideal choice,which is slightly affected by the chest infection,and operation is relatively simple,and do not need to make another incision drawn, while it could control local infection.All of these determine that pedicled intercostal muscle flap is an ideal esophageal repair material.From January 1995 to December 2010,38 study patients of our department are divided into two groups: Group I, mean age 56 years, taken a simple repair of the esophagus;group II, mean age 59 years, taken by esophageal repair and with pedicled intercostal muscle fixation, achieving the desired effect, most of them with A healing. Were followed up for six months to one year, patients are recovering well. Statistical comparison show that X2 test value is 3,87, P <0.05, statistically significant, so the group II patients with esophageal fistula was significantly lower than group I patients, suggesting that vascularized intercostal muscle flap helps the healing of esophagealanastomosis.