Nakatsuka T, Harii K, Ueda K, Ebihara S, Asai M, Hirano K, Yoshizumi T, Sugasawa T
Department of Plastic Surgery, Faculty of Medicine, University of Tokyo, Japan.
Head Neck. 1997 Mar;19(2):137-42. doi: 10.1002/(sici)1097-0347(199703)19:2<137::aid-hed9>3.0.co;2-5.
Preservation of the larynx after resection of a pharyngeal tumor remains a challenging problem for the head and neck surgeon.
Nine patients with T1 or T2 carcinoma of the posterior wall of the hypopharynx (UICC 1987), who were treated surgically between 1984 and 1994, were studied. All patients underwent surgical resection of the tumor with laryngeal preservation and immediate reconstruction with free flap transfer. A free forearm flap was transferred in four patients and a free jejunal patch graft, in five patients.
There was one flap loss, due to venous thrombosis. Successful larynx preservation was achieved in the remaining eight patients (89%). Although there was one local control failure, three patients remained free of disease for more than 5 years.
Laryngeal preservation surgery using a free flap patch graft has proven very beneficial in selected cases with a carcinoma of the posterior wall of the hypopharynx.
对于头颈外科医生而言，在切除咽肿瘤后保留喉仍然是一个具有挑战性的问题。
对1984年至1994年间接受手术治疗的9例下咽后壁T1或T2期癌（国际抗癌联盟1987年分期）患者进行了研究。所有患者均接受了保留喉的肿瘤手术切除，并立即进行游离皮瓣转移重建。4例患者采用游离前臂皮瓣转移，5例患者采用游离空肠补片移植。
1例因静脉血栓形成导致皮瓣丢失。其余8例患者（89%）成功保留了喉。尽管有1例局部控制失败，但3例患者无病生存超过5年。
在选定的下咽后壁癌病例中，使用游离皮瓣补片移植进行保喉手术已被证明非常有益。
