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喉气管组织瓣修复在喉咽癌的临床应用 预览

Application of laryngotracheal flap in reconstruction for carcinoma of hypopharynx
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摘要 目的总结喉咽癌累及喉和颈段食道的病例中,喉气管组织瓣在手术缺损修复中的临床应用。方法回顾近年来我院明确诊断7例较大范围的喉咽癌累及喉或颈段食道的手术病例,这些病人皆因喉咽癌累及到喉或颈段食道,肿瘤范围较大未能保留喉功能,而做了部分喉和/或部分食道上段切除术,并且采用未受肿瘤累及的残留部分喉体和气管瓣修复肿瘤被切除后的缺损,重建喉咽和食道。结果这7例病例用残留的部分喉气管组织瓣修复喉咽和颈段食道,术后病人吞咽功能恢复良好,其效果非常好。结论对于已经累及喉和颈段食道的喉咽癌,喉功能不能保留者,只要有足够未被肿瘤侵犯的喉和气管组织可利用,就用可保留下来的部分喉气管组织瓣修复重建喉咽和颈段食道的缺损。比较其他的修复方法,该手术方式创伤较小,病人生理功能恢复快,并发症少等优点。 Objective To review the laryngotracheal flap used in reconstruction of defect of hypopharynx and cervical esophagus postexcising the huge carcinoma of hypopharynx. Methods Retrospective review 7 cases with huge squamous cell carcinoma of hypopharynx extended larynx and/or cervical esophagus. The function of larynx could not be preserved for tumor size and invasion in operation, and the partial larynx and cervical esophagus were need resecting. The remnant partial larynx no tumor invasion and tracheal were used as flap for reconstruction of hypopharynx and cervical esophagus. Results The function of swallow recovered well post operation in reconstruction by laryngotracheal flap, and no complication happened. Conclusion Some part of larynx and tracheal , which be sure normal tissue and no tumor invasion, can be used as tissue flap in reconstructing hypopharynx and esophagus for those cases, which with huge carcinoma of hypopharyx involve larynx or/and cervical esophagus. Compare with other flap in repairing the defect of hypopharynx and cervical esophagus, the advantage of laryngotracheal flap is less surgical hurt, less complications, and more rapid recovering of physiological function.
作者 邓毅 吴元庆 陈尔东 初亭 陈荣荣 王俊 DENG Yi, WU Yuanqing, CHEN Erdong, CHU Ting, CHEN Rongrong, WANG Jun (Deptment of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, Chang 210006)
出处 《中国中西医结合耳鼻咽喉科杂志》 2015年第5期363-364,371共3页 Chinese Journal of Otorhinolaryngology of Integrated Traditional and Western Medicine
关键词 喉咽肿瘤 气管 外科皮瓣 修复 Hypopharyngeal Neoplasm Larynx Trachea Surgical Flap Reconstruction
作者简介 通信作者:邓毅,主任医师.Email:drdengyi@hotmail.com
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