Reconstruction surgery of hypopharyngeal carcinoma after pharyngolaryngectomy
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概要
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Sixty-three patients with hypopharyngeal carcinoma were treated by pharyngolaryngectomy at our institution between 1996 and 2000. There were the following two types of defects resulting from resection of carcinomas : 37 circumf erential pharyngeal defects and 26 partial pharyngeal defects. For the partial pharyngeal defect, 7 patients were reconstructed with primary closure of pharynx, and 19 patients with skin flap for patch reconstruction : 18 pectoralis major myocutaneons flaps (PMF) and one radial forearm flap. For the circumf erential defect, 12 patients were reconstructed with gastric pull-up (with esophageal carcinoma) and 19 patients with free jejunal autograf t (FGA). For the circumf erential defect in high-risk patients we utilized skin flaps (3 pectoralis major myocutaneous flaps, one radial forearm flap and 2 D-P flaps). Reconstructions with D-P flap were performed at the second-stage operation. Fistula formation occurred in 11.1% for all cases, and occurred more frequently in the PMF group than in the FGA group. About 5% of the patients had necrosis of grafts or flaps ; 8.3% in the gastric pull-up group, 5.3% in the FGA group, and 4.8% in the PMF group. In the circumf erential defect cases PMF was useful for the high-risk patients however, when pharynx was extensively resected including both tonsils, we recommended other flaps, especially PMF flaps. because partial necrosis of the flap easily occurs at the distal end of it.
- 特定非営利活動法人 日本頭頸部外科学会の論文
特定非営利活動法人 日本頭頸部外科学会 | 論文
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