论文部分内容阅读
目的 :探讨下咽癌术后下咽缺损Ⅰ期修复的方法。方法与结果 :对 31例下咽癌术后下咽缺损患者行Ⅰ期修复 ,其中下咽、喉和食管颈段切除加胃造瘘术 1例 ,无咽瘘发生 ;直接缝合修复 17例 ,吞咽功能良好 15例 (88.2 % ) ;组织移植修复 13例 ,吞咽功能良好 6例 (46 .2 % )。同时行喉功能保存性手术 14例 ,吞咽功能良好9例 ,均为直接缝合修复病例 ;吞咽功能差 5例 ,2例为直接缝合修复病例 ,3例为组织移植修复病例 ,均发生误吸。结论 :直接缝合大多数吞咽功能良好。对下咽全缺损的修复 ,胃肠上徙比肌皮瓣优越。同时行喉功能保存性手术 ,必须严格选择病例 ,并把误吸的预防放在首位。下咽、喉和食管颈段切除加胃造瘘术有助于扩大下咽癌的手术适应证。
Objective: To investigate the method of stage Ⅰ repair of hypopharyngeal carcinoma after hypopharyngeal carcinoma. Methods and Results: Thirty-one patients with hypopharyngeal carcinoma underwent phacoemulsification and phacoemulsification. One case was treated by resection of the hypopharynx, larynx and esophageal neck with gastrostomy, without pharyngeal fistula. Seventeen cases were directly sutured and repaired, Swallowing function was good in 15 cases (88.2%); tissue transplantation in 13 cases, swallowing function in 6 cases (46.2%). At the same time, 14 cases of preserving laryngeal function and 9 cases of good swallowing function were directly sutured repair cases. The swallowing function was poor in 5 cases, 2 cases were direct suture repair cases and 3 cases were tissue transplantation repair cases. Conclusion: Direct suture function most swallowing good. The repair of pharyngeal full defect, gastrointestinal migration superior to myocutaneous flap. At the same time the preservation of laryngeal surgery, must be strictly selected cases, and the prevention of aspiration in the first place. Hypopharyngeal, laryngeal and esophageal neck resection plus gastrostomy can help to expand the surgical indications for hypopharyngeal cancer.