Filippetti M, Graziano F, Santoro E, Marzetti F, Germain M A, Julieron N
Istituto Nazionale Tumori Regina Elena, Roma.
Chir Ital. 1999 May-Jun;51(3):193-8.
Reconstruction of the oro- and hypopharynx has specific difficulties duo to their wide diameters. Thirteen patients underwent reconstruction with a free U-shaped jejunal transplant, after circular pharyngo-laryngectomy for hypopharyngeal cancer invading the oropharynx. This transplant included a side-to-side anastomosis between the two limbs of the jejunal loop and allowed reconstruction of the upper digestive tract after wide carcinologic resection of the pharynx. The U-shaped jejunal transplant facilitated the upper anastomosis, especially the upper part where the resection involved the oropharynx. It formed a reservoir behind the tongue and avoided nasal reflux. Best indication are large resections involving the oropharynx.
由于口咽和下咽直径较大,其重建存在特殊困难。13例患者在因下咽癌侵犯口咽行环状咽喉切除术后,接受了游离U形空肠移植重建。该移植包括空肠袢两肢之间的侧侧吻合,并允许在广泛的咽癌切除术后重建上消化道。U形空肠移植便于上吻合,特别是在切除涉及口咽的上部。它在舌后形成一个贮器,避免鼻反流。最佳适应证是涉及口咽的大切除。