颏下岛状皮瓣一期修复下咽肿瘤切除后非环周缺损

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1、中国修复重建外科杂志2006年第20卷第12期·1183·颏下岛状皮瓣一期修复下咽肿瘤切除后非环周缺损蒋斌顾云飞陈卫贤徐新江【摘要】目的探讨颏下岛状皮瓣一期修复下咽非环周缺损的可行性、手术操作及疗效。方法回顾性分析1998年8月～2002年8月应用颏下岛状皮瓣修复下咽非环周缺损16例,男6例,女10例。年龄41～78岁。病理诊断均为鳞状细胞癌,部位:梨状窝9例,咽后壁4例,环后区3例。UICC(1997)临床分期:Ê期2例,Ë期11例,Ì期3例。切取皮瓣810cm×415cm～510cm×310cm。结果用颏下岛状皮瓣修复下咽非环周缺损16例皮瓣全部

2、成活,创口É期愈合。术后经3～7年随访,无咽瘘、感染等并发症,均恢复了良好的吞咽功能。术后3年时生存率为6818%(11ö16),5年生存率为6215%(5ö8)。结论用颏下岛状皮瓣修复下咽非环周缺损方法简便,成功率高,提高了生存率,是一种较好的下咽非环周缺损重建方法。【关键词】下咽肿瘤颏下岛状皮瓣非环周缺损修复中图分类号:R739.63R622文献标识码:ASUBMENTALISLANDFLAPSFORRECONSTRUCTIONOFHYPOPHARYNGEALNON-CIRCUMFERENTIALDEFECTSAFTERHYPOPHARYNGEA

3、LCARCINOMAREMOVALöJIANGBin,GUYunfei,CHENWeixian,etal.DepartmentofHeadandNeckSurgery,CancerHospitalofNantong,NantongJiangsu,226361,P.R.ChinaCorrespondingauthor:JIANGBin,E2mail:docbinjiang@yahoo.com.cn【Abstract】ObjectiveTostudythefeasibility,surgicaltechniques,andresultsofsubment

4、alislandflapsforreconstructionofhypopharyngealnon2circumferentialdefects.MethodsAretrospectivereviewofthearchiveswasperformedon16patients(6males,10females,aged41278years)whosufferedfromhypopharyngealcancer.FromAugust1998toAugust2002,thepatientsunderwentapartialremovalofthehypop

5、harynxandreconstructionbysubmentalislandflaps.Theirhypopharyngealcarcinomasbelongedtosquamouscarcinoma.Ofthe16patients(2inUICCclinicalstageÊ,11inË,3inÌ),9hadtheirpathologicalorigininthepyriformsinus,4intheposteriorpharyngealwall,and3inthepostcricoid.Theflaparearangedfrom810cm×4

6、.5cmto510cm×310cm.ResultsThefollow2upfor327yearsshowedthatthesubmentalislandflapshealedwellinallpatientswithasuccessrateof100%.Theswallowingfunctionreturnedtonormal10214daysafteroperationwithoutcomplicationsofsalivaryfistulaandinfection.The32yearand52yearsurvivalrateswere68.8%(

7、11ö16)and62.5%(5ö8),respectively.ConclusionSubmentalislandflapsareconvenientforreconstructionofhypopharyngealnon2circumferentialdefects,andtheyaresafeandreliable,too.【Keywords】HypopharyngealneoplasmSubmentalislandflapNon2circumferentialhypopharyngealdefectRepair下咽癌过去因缺少有效的修复重建手

8、段,常以放本组男6例,女10例。年龄41～78岁。均为下咽射治疗为主,疗效较差。近年来由于多种修复重建手癌。