Cargando…
Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy
Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoars...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Plastic and Reconstructive Surgeons
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801790/ https://www.ncbi.nlm.nih.gov/pubmed/29069877 http://dx.doi.org/10.5999/aps.2017.00941 |
_version_ | 1783298408052686848 |
---|---|
author | Park, Seong Hoon Kim, Joo Hyun Lee, Jun Won Jeong, Hii Sun Lee, Dong Jin Kim, Byung Chun Suh, In Suck |
author_facet | Park, Seong Hoon Kim, Joo Hyun Lee, Jun Won Jeong, Hii Sun Lee, Dong Jin Kim, Byung Chun Suh, In Suck |
author_sort | Park, Seong Hoon |
collection | PubMed |
description | Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture. |
format | Online Article Text |
id | pubmed-5801790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Society of Plastic and Reconstructive Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-58017902018-02-09 Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy Park, Seong Hoon Kim, Joo Hyun Lee, Jun Won Jeong, Hii Sun Lee, Dong Jin Kim, Byung Chun Suh, In Suck Arch Plast Surg Case Report Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture. Korean Society of Plastic and Reconstructive Surgeons 2017-11 2017-10-26 /pmc/articles/PMC5801790/ /pubmed/29069877 http://dx.doi.org/10.5999/aps.2017.00941 Text en Copyright © 2017 The Korean Society of Plastic and Reconstructive Surgeons This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Park, Seong Hoon Kim, Joo Hyun Lee, Jun Won Jeong, Hii Sun Lee, Dong Jin Kim, Byung Chun Suh, In Suck Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title | Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title_full | Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title_fullStr | Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title_full_unstemmed | Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title_short | Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy |
title_sort | is robot-assisted surgery really scarless surgery? immediate reconstruction with a jejunal free flap for esophageal rupture after robot-assisted thyroidectomy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801790/ https://www.ncbi.nlm.nih.gov/pubmed/29069877 http://dx.doi.org/10.5999/aps.2017.00941 |
work_keys_str_mv | AT parkseonghoon isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT kimjoohyun isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT leejunwon isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT jeonghiisun isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT leedongjin isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT kimbyungchun isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy AT suhinsuck isrobotassistedsurgeryreallyscarlesssurgeryimmediatereconstructionwithajejunalfreeflapforesophagealruptureafterrobotassistedthyroidectomy |