Plastic Surgery Department, China Medical University Hospital, Taichung, Taiwan.
Surgery. 2013 Mar;153(3):373-382.e2. doi: 10.1016/j.surg.2012.08.007. Epub 2012 Dec 4.
The free ileocolon flap has been considered a safe method of simultaneous restoration of swallowing and voice production; however, the management of complications at the recipient site and its impact on functional outcomes are lacking in the literature.
We reviewed retrospectively all consecutive patients with combined defects of the cervical esophagus and larynx reconstructed with free ileocolon flap between July 2005 and December 2009 (follow-up of ≥18 months). Patients were evaluated during the follow-up period to judge the impact of revision surgery on functional outcomes. Complications were reviewed, and the appropriate management was reported.
Swallowing function was restored in 69% of patient; functional speech function was achieved in 59%. Fourteen of the 29 patients underwent revision surgery because of complications or to improve functions at the recipient site. The mean functional improvement after revision surgery was 1.0 point on the 5-point Likert scale for speech and 1.1 point on the 7-point Likert scale for swallowing (P < .01 each).
Continuous research over the last 10 years has allowed us to refine the technique and to make the outcome more predictable.
游离回肠瓣已被认为是同时恢复吞咽和发声功能的安全方法；然而，文献中缺乏对受区并发症的处理及其对功能结果的影响的报道。
我们回顾性分析了 2005 年 7 月至 2009 年 12 月期间连续接受游离回肠瓣修复颈段食管和喉联合缺损的所有患者（随访时间≥18 个月）。在随访期间对患者进行评估，以判断修正手术对功能结果的影响。对并发症进行了回顾，并报告了适当的处理方法。
吞咽功能恢复的患者占 69%；实现了功能性言语功能的患者占 59%。29 例患者中有 14 例因并发症或改善受区功能而行修正手术。修正手术后，言语功能的平均改善为 5 分制 Likert 评分的 1.0 分，吞咽功能的平均改善为 7 分制 Likert 评分的 1.1 分（均 P <.01）。
过去 10 年的持续研究使我们能够改进技术，并使结果更具可预测性。
