摘要
BACKGROUND Tracheoesophageal fistula(TEF)is a life-threatening complication of advanced esophageal squamous cell carcinoma(ESCC).Cervical ESCC is rare and frequently diagnosed at an advanced stage.Managing cervical esophageal cancer(CEC)is challenging,requiring intervention by a multidisciplinary team(MDT)and innovative surgical management.CASE SUMMARY Here,we present a 59-year-old male patient with a 5-month history of CEC and difficulty eating for over 20 days,who developed TEF secondary to recurrent ESCC after chemoradiotherapy.He underwent total pharyngolaryngoesophagectomy,left thyroidectomy,and lymphadenectomy.Gastric pull-up was performed to restore gastrointestinal continuity,and a 7 cm×5 cm supraclavicular artery island flap(SCAIF)was used to reconstruct the lower tracheal defect.Despite severe postoperative complications,he recovered by successful management by a MDT.A 7 cm×6 cm pectoralis major myocutaneous flap was successfully used to repair the necrotic gastric conduit defect.The patient recovered,regaining the ability to eat and breathe effectively.At the 27-month follow-up,he was alive without recurrence or metastasis.CONCLUSION This study highlights the efficacy of gastric pull-up and SCAIF reconstruction in managing TEF secondary to recurrent ESCC.
基金
Supported by the Key R&D Program of Zhejiang,No.2023C03066
and National natural science foundation of China,No.82471148.
