用带血管蒂粘膜瓣及上段气管修复下咽和重建食管上段

Clinical study on hypopharyngeal defect repair and cervical esophagus reconstruction by vascular mucosal flap in patients with hypopharyngeal carcinoma

目的：探讨广泛侵犯的下咽癌或原发于咽后壁癌术后创面的修复和食管上段重建的方法。方法二报告2例广泛下咽癌同时有食管上段侵犯和1例咽后壁店，在切除下咽及颈段食管肿瘤后，利用未被肿瘤侵犯的喉和气管上段粘膜修复缺损区。结果：2例广泛侵犯的下咽癌术后均发生短时间咽瘘，其中1例随访3年健康，1例2年后局部复发放弃治疗；另1例咽后壁癌随访1年半健在。结论：广泛侵犯的下咽癌术后利用未被肿瘤侵犯的喉和气管修复创面和食管上段，在同一术野完成手术，方便，减少病人痛苦，尤其适合年老体弱不能耐受长时间大手术的病人。

Objective: A method of hypopharyngeal defect repair and cervicalesophagus reconstruction in patients with hypopharyngeal carcinoma was studied. Material:Three patients with hypopharyngeal carcinoma which invaded cervical esophagus(2 cases) and posterior wall of the pharynx (1 case) were studied. Results:Of these 3cases,one developed recurrent cancer after 2 years,the other two survived and 1. 5 and3 years postoperatively. Conclusion:The mentioned technique was convenient and easyespecially for aged patients.[Chinese Arch Otolaryngol Head Neck Surg, 1999; 6 (2 ): 89~91From the Department of Otolaryngology,The First Clinical College of Beijing MedicalUniversity,Beijing 100034 (Dr. Han Dekuan) ]