颈阔肌皮瓣在下咽癌术后缺损修复中的应用

发布时间：2018-06-30 20:25

本文选题：下咽肿瘤 + 诱导化疗　；参考：《临床耳鼻咽喉头颈外科杂志》2017年23期

【摘要】：目的:探讨颈阔肌皮瓣修复下咽癌术后组织缺损的方法及可行性。方法:应用颈阔肌皮瓣对12例下咽癌术后软组织缺损的患者进行修复。所有患者术前均行2次诱导化疗,并进行了保留喉功能的下咽癌手术和颈部淋巴结清扫术。结果:12例患者皮瓣全部存活。术后3周所有患者经口进食,无咽瘘,均有咽部异物感,但无吞咽困难。其中3例术后呛咳明显,训练后好转。术后均接受放疗,皮瓣无继发坏死。所有患者均保留了喉功能,除1例外其余都已拔管。结论:术前对下咽癌患者进行诱导化疗可有效缩小病灶。颈阔肌皮瓣血运丰富,抗感染力较强,成活率高,是修复下咽组织缺损行之有效的方法,手术方法简便,值得推广。
[Abstract]:Objective: to investigate the method and feasibility of latissimus myocutaneous flap in repairing postoperative tissue defect of hypopharyngeal carcinoma. Methods: 12 cases of soft tissue defect after hypopharyngeal carcinoma were repaired with latissimus myocutaneous flap. All patients were treated with induction chemotherapy twice before operation, laryngeal function preserving hypopharyngeal carcinoma surgery and neck lymph node dissection. Results all the 12 cases of skin flap survived. At 3 weeks after operation, all the patients had no pharyngeal fistula, no pharyngeal foreign body sensation, but no dysphagia. Among them, 3 cases had obvious cough after operation and improved after training. All patients received radiotherapy after operation, and no secondary necrosis of the flap was found. Laryngeal function was retained in all patients, except for 1 patient who had extubation. Conclusion: preoperative induction chemotherapy in patients with hypopharyngeal carcinoma can effectively reduce the focus. Latissimus cervicalis flap is an effective method for repairing hypopharynx tissue defect because of its rich blood supply, strong anti-infectious power and high survival rate. The operation method is simple and worth popularizing.
【作者单位】：上海市第一人民医院耳鼻咽喉头颈外科;
【分类号】：R739.63

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