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喉咽切除术后采用胸大肌肌皮瓣重建病例的评估

Evaluation of Cases Who Underwent Reconstruction Through Pectoralis Major Myocutaneous Flap after Laryngopharyngectomy.

作者信息

Somuk Battal Tahsin, Çiftçi Onur, Aygenç Erdinç

机构信息

Department of Otorhinolaryngology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey.

Department of Otorhinolaryngology, Private Güven Hospital, Ankara, Turkey.

出版信息

Turk Arch Otorhinolaryngol. 2016 Jun;54(2):58-62. doi: 10.5152/tao.2016.1603. Epub 2016 Jun 1.

Abstract

OBJECTIVE

In this retrospective study, we discussed the results of patients who underwent hypopharynx reconstruction through a pectoralis major myocutaneous flap (PMMF) after laryngopharyngectomy.

METHODS

Twenty-three patients who underwent total laryngectomy, subtotal pharyngectomy, and/or esophagus upper segment resection due to advanced-stage (T3 and T4) laryngeal, hypopharyngeal, and esophagus upper segment-located squamous cell carcinoma and subsequent reconstruction with PMMF were retrospectively evaluated. While the minor complications were determined to be wound site infection, hemorrhage, and disruption of suture at the donor site, major complications were determined to be anastomotic line disruption, fistula, and dysphagia.

RESULTS

Eighteen (78.2%) patients were male and five (21.7%) were female; their ages varied between 33 and 72 years (mean: 60.1). According to lesion localization, 11 patients were evaluated as having laryngeal cancer, seven as having hypopharyngeal cancer, and five as having esophagus upper segment-located cancer. The rate of minor complications was 30.4%: fistula was observed in 11 (47.8%) patients and 13 (56.5%) patients mentioned difficulty swallowing only solid foods. The total follow-up period ranged from 4 to 60 (mean: 31.6) months.

CONCLUSION

PMMF is continuing to be a good alternative reconstruction method for the reconstruction of partial hypopharyngeal defects because it is easily obtainable, one surgical team is sufficient when using the flap, and it is associated with low morbidity and mortality rates.

摘要

目的

在这项回顾性研究中,我们探讨了喉咽切除术后采用胸大肌肌皮瓣(PMMF)进行下咽重建的患者的治疗结果。

方法

回顾性评估了23例因晚期(T3和T4)喉、下咽及食管上段鳞状细胞癌而接受全喉切除、部分下咽切除和/或食管上段切除,随后采用PMMF进行重建的患者。轻微并发症被确定为伤口部位感染、出血和供区缝线断裂,主要并发症被确定为吻合口破裂、瘘管和吞咽困难。

结果

18例(78.2%)患者为男性,5例(21.7%)为女性;年龄在33至72岁之间(平均:60.1岁)。根据病变部位,11例患者被评估为患有喉癌,7例为下咽癌,5例为食管上段癌。轻微并发症发生率为30.4%:11例(47.8%)患者出现瘘管,13例(56.5%)患者仅提及吞咽固体食物困难。总随访期为4至60个月(平均:31.6个月)。

结论

PMMF仍然是重建部分下咽缺损的一种良好的替代重建方法,因为它易于获取,使用该皮瓣时一个手术团队就足够了,并且其发病率和死亡率较低。

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