Rath T, Grasl M C, Burian M, Swoboda H, Ehrenberger K, Piza-Katzer H, Roka R
Abtellung für Wiederherstellungs- und Plastische Chirurgie, Universitätsklinik für Chirurgie, Wien.
Handchir Mikrochir Plast Chir. 1997 Sep;29(5):269-75; discussion 276-7.
Since 1983, 90 autologous jejunal transplantations for reconstruction of the upper digestive tract have been performed in 89 patients (9 females, 80 males, average age 56.3 years). 73 patients were operated primarily, in 16 patients a recurrent tumor had been treated. One patient received a second jejunal graft after necrosis. In these heterogenous patients, the primary tumor was located in the hypopharynx 48 times, in the larynx 21 times, in the oropharynx 19 times and twice in the oral cavity. There was nearly always tumor stage III or IV without distant metastases. Following locoregional tumor resection, speech restoration was achieved 35 times by a siphon-like tube, and the upper digestive tract was reconstructed using a patch 18 times and by a tube 28 times. A combination of tube or patch with a siphon-like tube was employed 9 times. In only two of 16 patients with recurrent tumor, speech reconstruction was performed, in the other 14, the upper digestive tract was reconstructed. In those patients, in whom speech reconstruction (by siphon tube or by combination with tube/patch) was intended, this was achieved in 81.5%. Successful functional reconstruction of the upper digestive tract (by patch, tube, combination) could be achieved in about 60% of these patients.
自1983年以来,已对89例患者(9例女性,80例男性,平均年龄56.3岁)进行了90例自体空肠移植术以重建上消化道。73例患者为初次手术,16例患者为复发性肿瘤接受治疗。1例患者在空肠移植坏死之后接受了第二次空肠移植。在这些情况各异的患者中,原发肿瘤位于下咽48例次,位于喉21例次,位于口咽19例次,位于口腔2例次。几乎均为III期或IV期肿瘤,无远处转移。在进行局部肿瘤切除术后,通过虹吸样管实现言语恢复35例次,采用补片重建上消化道18例次,采用管重建28例次。管或补片与虹吸样管联合使用9例次。在16例复发性肿瘤患者中,仅2例进行了言语重建,另外14例进行了上消化道重建。在那些打算进行言语重建(通过虹吸管或与管/补片联合)的患者中,81.5%获得成功。这些患者中约60%实现了上消化道的成功功能重建(通过补片、管、联合方式)。