Leu Yi-Shing, Huang Chih-Ming, Yang Cheng-Chien, Hsiao Hung-Tao, Chang Yuan-Ching
Department of Otolaryngology-Head & Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Acta Otolaryngol. 2008 Jun;128(6):702-5. doi: 10.1080/00016480701636876.
Reconstruction after radical resection for advanced laryngeal and hypopharyngeal cancer can be carried out with low mortality, acceptable morbidity, and a promising functional outcome.
To evaluate the functional outcome of reconstruction by a free vascularized ileocolic flap after concurrent chemoradiotherapy (CCRT) and surgery for advanced laryngeal and hypopharyngeal cancer.
Fifteen patients (all male, mean age 49.8 years) with squamous cell carcinoma of larynx (n=1) or hypopharynx (n=14) received a circumferential pharyngolaryngectomy and resection of the proximal esophagus followed by postoperative CCRT (60-65 Gy, cisplatin and 5-fluorouracil). A single-stage reconstruction was performed with a free vascularized ileocolic flap using a microsurgical technique.
The course of all operations was uneventful. Eight patients were alive at a follow-up of 24 months after operation, while seven patients died from local recurrence, distant metastasis, and suicide. Relief of dysphagia was achieved in 14 cases. Speech intelligibility was recorded in five patients.
晚期喉癌和下咽癌根治性切除术后的重建手术死亡率低、并发症可接受且功能预后良好。
评估晚期喉癌和下咽癌同步放化疗（CCRT）及手术后采用游离带血管回结肠瓣重建的功能预后。
15例患者（均为男性，平均年龄49.8岁），其中喉鳞状细胞癌1例，下咽鳞状细胞癌14例，接受了环状咽喉切除术及近端食管切除术，术后进行CCRT（60 - 65 Gy，顺铂和5 - 氟尿嘧啶）。采用显微外科技术，使用游离带血管回结肠瓣进行一期重建。
所有手术过程均顺利。术后24个月随访时，8例患者存活，7例患者死于局部复发、远处转移和自杀。14例患者吞咽困难得到缓解。5例患者记录了言语清晰度。
