Pavlovics Gabor, Cseke Laszlo, Papp Andras, Tizedes Gyorgy, Tabar Bela A, Horvath Peter Ors
Department of Surgery, Medical School, University of Pecs, Pecs, Hungary.
Microsurgery. 2006;26(1):73-7. doi: 10.1002/micr.20216.
Following pharyngolaryngectomy, reconstruction is one of the most challenging surgical procedures. Here we review our own experiences using a microvascularly transferred free jejunal graft. This method was performed in 22 patients (19 male and 3 female, aged 40-63 years). Seven patients underwent neoadjuvant chemo-radiotherapy. Eighteen patients had immediate reconstruction after pharyngolaryngectomy, and 4 patients had delayed reconstruction because of complications from previous surgeries (2 stenoses, and 2 recurrent cancers). The duration of surgery ranged from 5-9 h (mean, 6.3 h), and the ischemic time of the graft was 70-125 min (mean, 88 min). This method has several advantages: it is a one-step operation; the graft is covered by self-cleaning mucosa; the development of fistulas and stenoses is rare; and the technique provides good swallowing. Owing to its good blood supply, this reconstructive method can also be used in previously irradiated areas.
喉咽切除术后，重建是最具挑战性的外科手术之一。在此，我们回顾我们自己使用微血管游离空肠移植的经验。该方法应用于22例患者（19例男性，3例女性，年龄40 - 63岁）。7例患者接受了新辅助放化疗。18例患者在喉咽切除术后立即进行了重建，4例患者因先前手术的并发症（2例狭窄和2例复发性癌症）而进行了延迟重建。手术时间为5 - 9小时（平均6.3小时），移植组织的缺血时间为70 - 125分钟（平均88分钟）。该方法有几个优点：它是一步手术；移植组织由自清洁黏膜覆盖；瘘管和狭窄的发生率很低；并且该技术能提供良好的吞咽功能。由于其良好的血供，这种重建方法也可用于先前接受过放疗的区域。
