Journal Article 上眼瞼脂腺癌に対し腫瘍切除術および眼瞼再建術を施行した1例

土橋, 七絵  ,  片山, 雄治  ,  権田, 恭広  ,  杤久保, 哲男  ,  堀, 裕一  ,  栃木, 直文  ,  澁谷, 和俊

62 ( 4 )  , pp.261 - 264 , 2015-12 , 東邦大学医学会
上眼瞼悪性腫瘍切除の際に,眼瞼再建を同時に施行した症例を経験したので報告する.症例は50歳女性.右上眼瞼外側の脂腺癌について腫瘍切除および上眼瞼再建を施行した.切除幅が17 mmに及び,単純縫縮による再建は困難であったため,Z形成術を用いて再建した.外眼角から耳介方向やや上方へ下に凸の切開線をデザインした.その結果,術後1週間で開瞼可能になり,3カ月ほどで創部はほとんど目立たなくなった.機能的にも大きな問題はなかった.結論として眼瞼悪性腫瘍切除後,欠損部が大きく単純縫縮による再建術が選択しがたい場合であっても,今回のようなZ形成術を用いることで端々縫合による再建が可能であり,術後の整容的・機能的合併症を減少させるうえで有用と考えられた.We report a case of upper eyelid reconstructive surgery using Z-plasty for an upper eyelid defect caused by excision of a malignant tumor. The patient was a 50-year-old woman. Malignant tumor excision and upper eyelid reconstructive surgery were performed for a sebaceous gland carcinoma on the outside of her right upper eyelid. The excision width was 17 mm and reconstruction by simple reefing was difficult. We therefore decided to perform Z-plasty reconstruction. The patient was able to open her eyes within approximately 1 week after reconstructive surgery. The surgical wound had almost disappeared within 3 months. The patient exhibited no functional difficulties. Reconstructive surgery with Z-plasty appears to be effective in reducing postoperative cosmetic and functional complications among patients for whom a reconstructive operation by simple reefing would be difficult due to the presence of a large defect after excision of a malignant eyelid tumor.

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