带蒂舌瓣修复下咽术后组织缺损12例报告

Glossus falp for hypopharyngeal reparation

目的:探讨修复下咽组织部分缺损的较好手术方法。方法:对12例晚期复发性喉癌及下咽癌患者,施行残喉或全喉切除及下咽部分切除后,设计以一侧舌深动脉为蒂的舌瓣,翻转向下,与保留的下咽粘膜及游离上提的颈段食道缝合,修复下咽组织缺损;以舌骨下肌群及斜方肌瓣加固下咽前外侧壁。结果:11例术后15d逐渐恢复吞咽功能;1例发生咽瘘,经换药延期20d进食。1年、3年和5年生存率分别为81.8%(911)、66.7%(69)及50%(36)。结论:带蒂舌瓣修复下咽组织缺损,具有取材方便、血供丰富、操作简单、成活率高和并发症少等优点。

Objective:To research the surgical type for hypopharyngeal reparation.Method:The glossus flap with glossus deep arterial was made to repairing hypopharyngeal breach after total laryngotomy and partial hypopharyngotomy in 12 cases of repeated laryngeal carcinoma and hypopharyngeal carcinoma.Result:11 cases recovered in the swallowing function after 15 days and the pharyngeal fistula took place in one case,but healed in 35 days postoperatively.The survival rates in 1 year,3 years and 5 years were 81.8 %, 66.7 % and 50% respectively.Conclusion:The glossus flap is good material for hypopharyngeal reparation with rich blood supply,few complication and high survival rates.