原发性颈段气管癌的外科治疗
[Surgical management of primary cervical tracheal cancer].
作者信息
Pan Xin-liang, Lei Da-peng, Xu Feng-lei, Zhang Li-qiang, Liu Da-yu, Xie Guang, Luan Xin-yong
机构信息
Department of Otorhinolaryngolgy, Qilu Hospital of Shandong University, Jinan 250012, China.
出版信息
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2003 Dec;38(6):437-9.
OBJECTIVE
To review the experience of surgical treatment of primary cervical tracheal cancer.
METHODS
Six patients with primary cervical tracheal cancer were treated surgically from January 1997 to April 1999. The trachea anastomosis, platysmamyocutaneous flap combiend with the facial flap of the sternohyoid muscle, sternocleidomastoid myoperiosteal flap and the pectoralis major muculocutaneous flap were applied to restore the defects of cervical trachea. By pathology, there were two squamous cell carcinomas, three adenoid cystic carcinomas, and one adenocarcinoma.
RESULTS
Six cases were decannulated from 23 days to 3 months after operation. The length of follow-up was more than 3 years. Five cases have stable airway by fiberscope and good voice after decannulation and there is no recurrence. One case died of lung metastasis 2 years after operation.
CONCLUSION
Trachea anastomosis is suited for small partial defect. The platysmamyocutaneous flap combined with the facial flap of the sternohyoid muscle, sternocleidomastoid myoperiosteal flap and the pectoralis major muculocutaneous flap are ideal transplant for cervical tracheal reconstruction.
目的
回顾原发性颈段气管癌的外科治疗经验。
方法
1997年1月至1999年4月对6例原发性颈段气管癌患者进行手术治疗。应用气管吻合术、颈阔肌肌皮瓣联合胸骨舌骨肌肌瓣、胸锁乳突肌肌骨膜瓣及胸大肌肌皮瓣修复颈段气管缺损。病理检查显示，有2例鳞状细胞癌、3例腺样囊性癌和1例腺癌。
结果
6例患者术后23天至3个月拔管。随访时间超过3年。5例患者拔管后纤维喉镜检查气道通畅，声音良好，无复发。1例患者术后2年死于肺转移。
结论
气管吻合术适用于小范围的部分缺损。颈阔肌肌皮瓣联合胸骨舌骨肌肌瓣、胸锁乳突肌肌骨膜瓣及胸大肌肌皮瓣是颈段气管重建的理想移植材料。
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