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目的:评估改良颏下岛状皮瓣在下咽癌喉功能保留手术中的应用及其临床效果。方法:回顾分析38例应用颏下岛状皮瓣修复保留喉功能的下咽癌患者的临床资料,通过对颏下皮瓣的血管蒂的设计、下咽癌切除后喉、下咽功能的重建方式以及颏下皮瓣切取后颈部伤口的关闭等方面进行改良和应用,并综合评估改良颏下岛状皮瓣应用于下咽癌喉功能保留手术患者的效果及预后。结果:38例患者术后颏下皮瓣均成活。随访期内18例死亡,其中7例死于第二原发癌,分别为4例食管癌,1例软腭癌,2例鼻咽癌;5例死于颈部或咽旁淋巴结复发;2例死于肝转移;4例死于肺转移。总体5年生存率52.6%。结论:改良颏下岛状皮瓣应用于下咽癌保留喉功能手术缺损重建具有成功率高、安全、简便及疗效良好等优点,值得临床推广应用。
Objective: To evaluate the clinical application of modified submental island flap in laryngeal function preservation surgery of hypopharyngeal carcinoma. Methods: The clinical data of 38 patients with hypopharyngeal carcinoma preserving laryngeal function repaired by submental island skin flap were retrospectively analyzed. Through the design of the pedicle of the submental flaps, the reconstruction of laryngeal and hypopharyngeal function after hypopharyngeal carcinoma resection Method and submental flap after the closure of the neck wound to improve and application, and comprehensive evaluation of the modified submental island flap for hypopharyngeal cancer patients with laryngeal function retention and prognosis. Results: All 38 patients underwent submental flaps survived. Eighteen deaths occurred during the follow-up period, of which seven died of second primary cancer, four were esophageal cancer, one soft palate cancer, two nasopharyngeal carcinomas, five died of cervical or parapharyngeal lymph node recurrence, and two Died of liver metastases; 4 died of lung metastases. The overall 5-year survival rate was 52.6%. Conclusion: The modified submental island flap has the advantages of high success rate, safety, convenience and good curative effect in hypopharyngeal carcinoma laryngeal reconstruction. It is worthy of clinical application.