咽-喉切除术联合筋膜皮瓣游离重建与唾液旁路管后的结果。
Outcomes following pharyngolaryngectomy with fasciocutaneous free flap reconstruction and salivary bypass tube.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain.
出版信息
Laryngoscope. 2013 Mar;123(3):591-6. doi: 10.1002/lary.23695. Epub 2012 Sep 5.
OBJECTIVES/HYPOTHESIS: Reconstruction of the pharyngoesophageal defects is one of the most challenging for head and neck surgeons. We evaluated our experience in the hypopharyngeal reconstruction using a fasciocutaneous free flap in conjunction with a Montgomery salivary bypass tube (MSBT).
STUDY DESIGN
Retrospective review.
METHODS
The charts of 55 patients who had undergone hypopharynx reconstruction using either a radial forearm free flap (RFFF) (24) or an anterolateral thigh (ALT) flap (31) with MSBT were reviewed. There were 40 circumferential and 15 near-circumferential defects. Outcomes analyzed included fistula and stricture rates and swallowing function.
RESULTS
Pharyngocutaneous fistula occurred in 9% of patients (16% using RFFF and 3% using ALT), and strictures occurred in 5% (8% using RFFF and 3% using ALT). Of patients reconstructed with this technique, 95% were able to resume oral alimentation.
CONCLUSIONS
The use of fasciocutaneous free flaps in conjunction with the MSBT is a useful tool for pharyngoesophageal reconstruction.
目的/假设：咽食管缺损的重建是头颈部外科医生面临的最具挑战性的问题之一。我们评估了使用筋膜皮瓣联合蒙哥马利涎管旁路（MSBT）进行下咽重建的经验。
研究设计
回顾性研究。
方法
回顾了 55 例接受下咽重建的患者的病历，其中 24 例使用桡侧游离皮瓣（RFFF），31 例使用股前外侧皮瓣（ALT）联合 MSBT。其中 40 例为环形缺损，15 例为近环形缺损。分析的结果包括瘘管和狭窄的发生率以及吞咽功能。
结果
咽皮瘘的发生率为 9%（使用 RFFF 的为 16%，使用 ALT 的为 3%），狭窄的发生率为 5%（使用 RFFF 的为 8%，使用 ALT 的为 3%）。采用该技术重建的患者中，95%能够恢复经口进食。
结论
使用筋膜皮瓣联合 MSBT 是咽食管重建的一种有效工具。
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