Zhang Xiangmin, Liu Folin, Lan Xiaolin, Luo Keqing, Xiao Fufu, Li Shaojin
Department of Head and Neck Surgery, Ganzhou Tumor Hospital, Ganzhou, Jiangxi 341000, P.R. China.
Institute of Cancer Research, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China.
Oncol Lett. 2016 Mar;11(3):1815-1818. doi: 10.3892/ol.2016.4152. Epub 2016 Jan 26.
The treatment of pharyngeal fistulas is complicated. It is more difficult to deal with pharyngeal fistula following surgical treatment for hypopharynx carcinoma, particularly in cases of pectoralis major muscle flap repair. The present study describes the case of a 56-year-old man who presented with a highly-differentiated pharyngeal squamous cell carcinoma located at the right side of the hypopharynx. The patient underwent a total laryngectomy and a right functional carotid dissection and tracheostomy; this was followed by post-operative radiotherapy. A pharyngeal fistula subsequently developed, but an attempt to repair this with a pectoralis major muscle flap failed. The complicated pharyngeal fistula was treated via continuous negative pressure-flush through a dual tube, without the requirement for incision, daily dressing or antibiotics. The favorable patient outcome represented a positive result, which was also able to reduce the psychological burden of the patient and improve their quality of life.
咽瘘的治疗较为复杂。下咽癌手术治疗后处理咽瘘更加困难,尤其是在采用胸大肌肌皮瓣修复的情况下。本研究描述了一名56岁男性的病例,该患者患有位于下咽右侧的高分化咽鳞状细胞癌。患者接受了全喉切除术、右侧功能性颈动脉清扫术和气管切开术;随后进行了术后放疗。之后出现了咽瘘,但尝试用胸大肌肌皮瓣修复失败。通过双腔管持续负压冲洗治疗复杂咽瘘,无需切开、每日换药或使用抗生素。患者良好的预后是一个积极的结果,这也能够减轻患者的心理负担并提高其生活质量。