【作者】 李树春； 李振东； 刘文中；

【Author】 Li Shu-Chun Li Zhen-Dong Liu Wen-Zhong Department of head and neck surgery, Liaoning Tumor Hospital. Shenyang, CHINA

【机构】 辽宁省肿瘤医院头颈外科；

【摘要】 目的:前瞻性研究应用复合的喉气管瓣及胸大肌肌皮瓣,重建下咽癌广泛切除环周下咽及颈段食管缺损的可靠性、有效性及其近远期疗效。方法:自2002年12月至2005 年4月,共有20例晚期下咽癌患者应用手术进行了治疗。均为男性。其中T3 7例,T4 13例。手术切除后均造成2～7 厘米长的环周缺损,全部应用复合的对侧未受累及的喉气管瓣及胸大肌肌皮瓣进行重建。结果:全部20例重建之复合瓣均成活,除有2例发生小的咽瘘外,其余18例创口均一期愈合,无任何并发症发生。全组无手术死亡。全部病例术后均可经口进普通饮食,X线钡餐造影无梗阻或狭窄。随诊期7～ 40个月,中位随诊期27个月。有2例分别于术后7和12个月时因颈转移复发死亡外,其余18例均无瘤生存。结论:结果显示此项技术操作简便,安全、可靠而且功能效果良好。并发症少而轻微,肿瘤效果充分。更多还原

【Abstract】 Objective: Prospectively to study the combined laryngotracheal flap and pectoralis major myocutaneous flap to reconstructe the circumferential hypopharyngo-esophageal defects after radical surgery. Its effects, reliability and short and long term results. Methods: Between December 2002 and April 2005,20 patients with advanced hypopharyngeal cancer received surgery. All of them are men, including T3 seven cases and T4 thirteen cases. After the surgery resulting a 2-7 cm circumferential defects of hypopharyngoesophageal area, which was reconstructed with combined contralateral unaffected laryngotracheal flap and patch-on pectoralis major myocutaneous flap. Results: All of 20 combined flaps are alive. Only two minor pharyngo- cutaneous fistulas were found postoperatively. The wound healing was good postoperatively in other 18 cases. There were no motality in all of 20 patients. All of 20 patients can resume a regular diet, the swallowing function was good by X-ray examination and no stricture was found. During follow-up period (7-40 months, median,27 months), there were no local recurrences in all of 20 patients. Two cervical recurrences and died in 7 and 12 months, but other 18 patients free of tumor alived. Conlusion: The liminary result shows that this technique is a simple, safe and effective method with low morbidity and satisfactory oncologic and functional results.更多还原