组织转移至放化疗后挽救性喉切除术缺损处预防咽皮肤瘘：单中心经验
Tissue transfer to post-chemoradiation salvage laryngectomy defects to prevent pharyngocutaneous fistula: single-centre experience.
作者信息
Powell J, Ullal U R, Ahmed O, Ragbir M, Paleri V
机构信息
Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
出版信息
J Laryngol Otol. 2014 Apr;128(4):365-367. doi: 10.1017/S0022215114000504.
BACKGROUND
In recent practice, we have used tissue transfer (pedicled or free flap) to augment the pharyngeal circumference of the neopharynx following salvage total laryngectomy, even in patients who have sufficient pharyngeal mucosa for primary closure. In this study, the rates of pharyngocutaneous fistula were compared in soft tissue flap reconstructed patients versus patients who underwent primary closure.
METHOD
A retrospective assessment was carried out of all patients who had undergone a salvage total laryngectomy between 2000 and 2010. The presence or absence of a pharyngocutaneous fistula was compared in those who received reconstruction closure versus those who received primary closure.
RESULTS
The reconstruction closure group ( = 7) had no incidence of pharyngocutaneous fistula, whereas the primary closure group ( = 38) had 10 fistulas, giving pharyngocutaneous fistula rates of 0 per cent versus 26 per cent, respectively.
CONCLUSION
The findings revealed a lower rate of pharyngocutaneous fistula with tissue transfer compared with primary closure of the neopharynx.
背景
在最近的临床实践中，我们采用组织转移（带蒂或游离皮瓣）来扩大挽救性全喉切除术后新咽的咽周径，即使是那些有足够咽黏膜进行一期缝合的患者。在本研究中，比较了软组织瓣重建患者与一期缝合患者的咽皮肤瘘发生率。
方法
对2000年至2010年间所有接受挽救性全喉切除术的患者进行回顾性评估。比较接受重建缝合的患者与接受一期缝合的患者是否存在咽皮肤瘘。
结果
重建缝合组（n = 7）无咽皮肤瘘发生，而一期缝合组（n = 38）有10例瘘管形成，咽皮肤瘘发生率分别为0%和26%。
结论
研究结果显示，与新咽一期缝合相比，组织转移的咽皮肤瘘发生率较低。
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