Ishida Katsuhiro, Kato Takakuni, Seino Youichi, Uchida Mitsuru
Department of Plastic and Reconstructive Surgery.
J Plast Surg Hand Surg. 2014 Oct;48(5):291-6. doi: 10.3109/2000656X.2013.877914. Epub 2014 Jan 20.
Surgical resection of hypopharyngeal cancer often affects laryngeal function. The aim of this study is to assess the reliability and efficacy of free skin flap transfer after partial hypopharyngectomy with laryngeal preservation. This study designs a retrospective analysis. The subjects were 54 patients who underwent free skin flap reconstruction immediately after partial pharyngolaryngectomy or hypopharyngectomy with laryngeal preservation. The defects were classified into four types based on the location of the hypopharyngeal defect. Functional results were evaluated by routine physical examination findings and parameters related to swallowing function and X-ray barium deglutition examination. Perioperative mortalities and morbidities were reviewed. There were no perioperative mortalities and 98% of the flaps survived. Forty-three patients (80%) were able to eat an unrestricted diet and experienced no aspiration. Restriction of the diet was significantly associated with the extent of oesophageal mucosal resection. In conclusion, free skin flap reconstruction is confirmed to be a safe and effective strategy to maintain laryngeal function and good quality-of-life.
下咽癌的手术切除常常会影响喉功能。本研究的目的是评估保留喉的部分下咽切除术后游离皮瓣转移的可靠性和疗效。本研究设计了一项回顾性分析。研究对象为54例在部分喉咽切除术或保留喉的下咽切除术后立即接受游离皮瓣重建的患者。根据下咽缺损的部位将缺损分为四种类型。通过常规体格检查结果以及与吞咽功能相关的参数和X线吞钡检查来评估功能结果。回顾围手术期死亡率和发病率。围手术期无死亡病例，皮瓣存活率为98%。43例患者（80%）能够正常饮食且无呛咳。饮食受限与食管黏膜切除范围显著相关。总之，游离皮瓣重建被证实是一种维持喉功能和良好生活质量的安全有效的策略。
