Marusch F, Koch A, Kluge J, Stöbe R, Immer P, Gastinger I
Chirurgische Klinik, Carl-Thiem-Klinikum Cottbus.
Zentralbl Chir. 1998;123(8):944-9.
Based on animal trials the presented study results describe a laparoscopic assisted removal of an extra-long free jejunal graft to reconstruct voice and swallowing after a total laryngo-pharyngectomy in cases with advanced malignancies of the larynx including invasion in the upper oesophagus. With a microvascular anastomosed small bowel segment, we have been able to reconstruct parts of the pharynx and to create a speaking syphon as devised by Ehrenberger in an one-stage procedure. The concept of avoidance of an extensive laparotomy may result in an decreased morbidity of this surgical procedure. Therefore it represents a challenging single indication of minimally invasive surgery of the oesophagus. A well established interdisciplinary teamwork is the key for success in this extensive procedure.
基于动物试验,本研究结果描述了在喉高级别恶性肿瘤(包括侵犯上段食管)行全喉咽切除术后,采用腹腔镜辅助切除超长游离空肠移植物来重建语音和吞咽功能。通过微血管吻合的小肠段,我们能够在一期手术中按照埃伦伯格设计的方法重建部分咽腔并形成一个发声管。避免广泛开腹手术的理念可能会降低该手术的发病率。因此,它代表了食管微创手术中一项具有挑战性的单一适应证。一个成熟的跨学科团队合作是这一复杂手术成功的关键。