Graville Donna J, Palmer Andrew D, Chambers Christine M, Ottenstein Lauren, Whalen Breanne, Andersen Peter E, Wax Mark K, Cohen James I
Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon.
Portland VA Medical Center, Portland, Oregon.
Head Neck. 2017 Nov;39(11):2319-2328. doi: 10.1002/hed.24902. Epub 2017 Aug 24.
The purpose of this study was to compare long-term functional and quality of life (QOL) outcomes after total laryngectomy with primary closure and those who underwent reconstruction with noncircumferential radial free forearm tissue transfer (RFFTT).
Sixty-seven patients were identified by chart review and underwent long-term follow-up using QOL surveys and standardized interviews.
The RFFTT group had significantly higher rates of chemotherapy, gastric tube (G-tube) at surgery, and postoperative stricture. At follow-up, most patients (88%) had a tracheoesophageal prosthesis (TEP) and were using it as their primary communication method. Diet and swallowing outcomes were comparable and no one had a G-tube. Device life and TEP complications did not differ significantly. Only voice-related QOL differed significantly between the RFFTT group and those who had undergone total laryngectomy without adjuvant treatment.
Despite more extensive treatment, the reconstructed group achieved comparable outcomes to those who had undergone total laryngectomy with adjuvant treatment.
本研究的目的是比较全喉切除术后一期缝合与接受非环形桡侧游离前臂组织瓣转移术（RFFTT）重建患者的长期功能和生活质量（QOL）结果。
通过病历回顾确定了67例患者，并使用生活质量调查问卷和标准化访谈进行长期随访。
RFFTT组化疗、手术时胃管（G管）置入和术后狭窄的发生率显著更高。随访时，大多数患者（88%）有气管食管发音钮（TEP），并将其作为主要交流方式。饮食和吞咽结果相当，没有人使用G管。装置使用寿命和TEP并发症无显著差异。仅RFFTT组与未接受辅助治疗的全喉切除患者在与语音相关的生活质量方面存在显著差异。
尽管治疗范围更广，但重建组的结果与接受辅助治疗的全喉切除患者相当。
