Chu Pen-Yuan, Chang Shyue-Yih
Department of Otolaryngology, Veterans General Hospital-Taipei, National Yang-Ming University, 201, Sec 2, Shih-Pai Road, Taipei, Taiwan.
Head Neck. 2002 Oct;24(10):933-9. doi: 10.1002/hed.10149.
Hypopharyngeal cancer often presents at an advanced stage. Radical surgery has played an important role in the treatment of these cases; however, it always results in a large, or even a circumferential, defect of the pharyngoesophageal segment (PES) that causes some difficulties during reconstruction.
Twelve patients with advanced hypopharyngeal cancer and cervical esophageal invasion received surgery resulting in a circumferential defect of PES, which was reconstructed with the contralateral unaffected laryngotracheal flap and a patch-on pectoralis major myocutaneous flap (PMMCF).
The operation time of this method was shorter compared with free flap reconstruction. Only two minor complications and no pharyngocutaneous fistulas were found postoperatively. Nine patients can resume a regular diet. During the follow-up period (median, 38 months), there were no local recurrences and only one contralateral neck recurrence.
The preliminary result shows this technique is a simple and effective method with low morbidity and satisfactory oncologic and functional results.
下咽癌常于晚期出现。根治性手术在这些病例的治疗中发挥了重要作用；然而，它总会导致下咽食管段（PES）出现大面积甚至环形缺损，这在重建过程中会引发一些困难。
12例晚期下咽癌伴颈段食管侵犯患者接受了手术，导致PES出现环形缺损，采用对侧未受影响的喉气管瓣和带蒂胸大肌肌皮瓣（PMMCF）进行重建。
与游离皮瓣重建相比，该方法的手术时间更短。术后仅发现2例轻微并发症，未出现咽皮肤瘘。9例患者可恢复正常饮食。在随访期（中位时间为38个月），无局部复发，仅1例对侧颈部复发。
初步结果表明，该技术是一种简单有效的方法，发病率低，肿瘤学和功能效果良好。
