Burstein F D, Calcaterra T C
Arch Otolaryngol Head Neck Surg. 1987 Jan;113(1):73-7. doi: 10.1001/archotol.1987.01860010077019.
Surgery of the lower neck and superior mediastinum is most frequently performed for parastomal recurrence of laryngeal carcinoma. It has been associated with a high incidence of complications, often leading to fatal innominate artery rupture. The use of the pectoralis major myocutaneous flap has permitted wide en bloc resections of the superior mediastinum in ten patients without a major complication. Several technical innovations add versatility to the pectoralis major myocutaneous flap, including tailor fitting each skin paddle and incorporating the pectoralis minor into the muscular pedicle. Superior mediastinal resection should be performed in conjunction with laryngectomy and cervical lymph node dissection in patients who are at high risk for parastomal recurrence. We also recommend that patients with parastomal recurrence undergo this procedure for salvage.
下颈部和上纵隔手术最常用于喉癌造口旁复发。它与高并发症发生率相关，常导致致命的无名动脉破裂。胸大肌肌皮瓣的应用使得10例患者能够对上纵隔进行广泛整块切除且无重大并发症。多项技术创新增加了胸大肌肌皮瓣的通用性，包括对每个皮瓣进行定制裁剪以及将胸小肌纳入肌蒂。对于造口旁复发高危患者，上纵隔切除应与喉切除术和颈部淋巴结清扫联合进行。我们还建议造口旁复发患者接受此手术进行挽救。
