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全喉切除后发声重建术的并发症如唾液和食物的吸入、分路的狭窄等并不少见。为克服上述缺点,作者利用上段的气管环作新声门并使其突入食管。手术方法为先在四、五气管环水平作气管造口。在第一气管环上方完成喉切除术。利用上段的三个气管环重建新声门,将气管上端的前、后壁分别作V型部分切除,剥脱第一气管环内面上皮以便与食管壁缝合。在食管前壁作1长1cm全层的垂直切口,其位置正好在气管断端的上面。先将气管后壁的V型缺损拉近,牵拉食管前壁切口周围用褥式缝合固着在已剥脱内膜的气管内,两侧各缝合3、4针;然后再将气管前壁V形缺
Total laryngectomy after vocal reconstruction of complications such as saliva and food intake, narrowing of the shunt is not uncommon. To overcome these shortcomings, the authors used the tracheal ring in the upper segment as a new glottis and into the esophagus. Surgical methods for the first four or five tracheal ring level for tracheostomy. Complete laryngectomy above the first tracheal ring. Using the three tracheal rings in the upper section to reconstruct the new glottis, the front and back walls at the upper end of the trachea are respectively resected with a V-shaped part to exfoliate the inner surface of the first tracheal ring so as to be sutured with the esophageal wall. In the anterior esophagus for a full 1cm long vertical incision, its position just above the tracheal stump. The first tracheal V-shaped defect near the wall, pulling the anterior esophageal incision around the mattress suture has been fixed in the stripped endotracheal trachea, both sides of the stitches 3,4 needle; and then the anterior tracheal V-shaped lack