de Vries E J, Myers E N, Johnson J T, Shestak K, Schusterman M A, Petruzzelli G J, Jones N F, Wagner R
Department of Otolaryngology, Eye and Ear Hospital, University of Pittsburgh School of Medicine, Pennsylvania.
Ann Otol Rhinol Laryngol. 1990 Jun;99(6 Pt 1):496-8. doi: 10.1177/000348949009900616.
Complications following total laryngectomy may include pharyngocutaneous fistula or pharyngeal stricture. Traditional techniques of repair of fistula and stricture with local or regional flaps lead to a high rate of failure. In this study, we report 18 patients treated by secondary jejunal interposition (JI) to rehabilitate swallowing following recalcitrant postlaryngectomy stricture or fistula. All patients had undergone total laryngectomy with or without partial pharyngectomy for treatment of squamous cell carcinoma of the larynx (8) or hypopharynx (10). Four were stage II; 5, stage III; and 9, stage IV. Thirteen patients (72%) regained swallowing function. Complications of secondary JI included perioperative death (2), flap loss (1), and persistent fistulas (3). Jejunal interposition may be the best modality in the rehabilitation of swallowing in patients with persistent fistula or stricture that fails to respond to traditional management.
全喉切除术后的并发症可能包括咽皮瘘或咽狭窄。采用局部或区域皮瓣修复瘘管和狭窄的传统技术失败率很高。在本研究中，我们报告了18例接受二期空肠间置术（JI）治疗的患者，这些患者因喉切除术后顽固性狭窄或瘘管而需要恢复吞咽功能。所有患者均接受了全喉切除术，其中8例为喉鳞状细胞癌，10例为下咽鳞状细胞癌，部分患者还接受了部分咽切除术。4例为II期；5例为III期；9例为IV期。13例患者（72%）恢复了吞咽功能。二期空肠间置术的并发症包括围手术期死亡（2例）、皮瓣坏死（1例）和持续性瘘管（3例）。对于持续性瘘管或狭窄且对传统治疗无反应的患者，空肠间置术可能是恢复吞咽功能的最佳方式。
