切除手術と再建手術 (下咽頭・頚部食道癌治療の進歩<シンポジウム>)
スポンサーリンク
概要
- 論文の詳細を見る
Complete resection and primary reconstruction are both the most important factors in the treatment of hypopharyngeal and cervical esophageal cancers. In order to secure the resection level superiorly at the oropharynx and inferiorly at cervical esophagus, margin studies of extirpated specimens were done. About 20% of examined cases showed positive margins at the oropharyngeal stump and 10% at the esophageal stump. Cancers extending below the level of Th2 showed a high incidence of skip lesions in the lower esophagus. Specimens of early pyriform sinus cancers, which were extirpated with the preservation of the larynx, showed positive margins only in a few cases and only at their oropharyngeal margins.<BR>These results indicate that hypopharyngeal cancers may have a deep invasion' into the oropharynx and should be resected high up to the level of the palatine tonsil, and that total esophagectomy is advisable in case with cervical esophageal cancers to eliminate possible skippings.<BR>The reconstructive technique should be selected to ensure better matching to these defects. One-stage reconstruction is essential, enabling an earlier application of postoperative therapy. Staged technique is thus abandoned. Among many options of one-stage techniques, we prefer the pectoralis major myocutaneous island flap for hypopharyngeal cancers and vascularized stomach or colon for cervical esophageal cancers. Several technical devices were demonstrated in the use of the pectoralis major myocutaneous flap for female patients with buxom breast, otherwise the flap is not indicated because of its bulkiness.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
- Autopsy Cases of 14 Children with Foreign Bodies in the Airway.
- タイトル無し
- Symposium 1:Pathophysiology of the hypopharynx and esophagus in the geriatric age group. A. Surgical treatment for the aged patients with cancer of the thoracic esophagus.
- Endoscopic Surgery. Thoracoscopic Surgery for Esophageal Submucosal Tumors.
- Glottic Closure for the Treatment of Recurrent Aspiration Pneumonia in Severely Handicapped Young Persons.