Stafford N D, Matthews R N
Head and Neck Unit, Royal Marsden Hospital, London.
J Laryngol Otol. 1988 Jan;102(1):45-8. doi: 10.1017/s0022215100103937.
Stricture formation may occur after pharyngolaryngectomy if less than one half of the circumference of the pharynx is available for primary closure. However, the alternative of total pharyngectomy with skin flap or visceral replacement carries with it a high mortality and morbidity rate. In an attempt to overcome these problems, a policy of patch grafting the pharyngeal defect with a myocutaneous flap or segment of free vascularised jejunum has been adopted whenever a strip of pharyngeal mucosa greater than one centimetre in width remains after excision of the tumour. A good post-operative swallow has been achieved in all cases.
如果咽周径不足一半可用于一期缝合，那么在喉咽切除术后可能会形成狭窄。然而，采用皮瓣或内脏替代进行全咽切除术的替代方案具有较高的死亡率和发病率。为了克服这些问题，只要在肿瘤切除后残留一条宽度大于1厘米的咽黏膜条带，就会采用用肌皮瓣或游离血管化空肠段修补咽缺损的策略。所有病例术后吞咽功能均良好。
