裂层皮片和胸大肌肌皮瓣在保留喉功能喉咽癌手术中的应用  

The application of split flap and ectopectoralis musculocutaneous flap in reserving the laryngeal function in the resection of the hypopharyngeal cancer

作　　者：潘新良[1] 栾信庸[1] 许风雷[1] 刘大昱[1] 张立强[1] 雷大鹏[1] 

机构地区：[1]山东医科大学附属医院耳鼻咽喉科,250012

出　　处：《山东医大基础医学院学报》2000年第4期227-228,共2页

摘　　要：目的 :研究如何在保留喉功能喉咽癌切除术后应用裂层皮片加胸大肌肌皮瓣整复组织缺损。方法 :总结 1988至 1998年 17例保留喉功能喉癌切除术后利用裂层皮片加胸大肌肌皮瓣整复组织缺损的临床资料。肿瘤原发于咽后壁区 6例 ,原发于梨状窝区 11例。结果 :10例恢复了喉的全部功能 ,7例恢复了喉的部分功能。随访 1～ 8年。 17例中半年内复发 1例 ,再次手术后 1年肿瘤再次复发死亡。 3例术后 1 5～ 2年颈部淋巴结转移 ,经行改良根治性颈廓清术现健在。 1例上纵隔转移 ,1例肺转移 ,经保守治疗无效死亡。 3年生存率为 62 8%。 5年生存率为 4 1 0 %。结论Objetive:To study application of split flap and ectopectoralis musculocutaneous flap in the resection of the hypopharyngeal cancer with the laryngeal reservation.Methods:17 patients who had been applied the two flaps simultaneously to repair the defects were summaried from 1992 to 1998.Among them,6 cases were the primary tumor originated in hypopharyngeal posterior;11 cases,the primary tumor originated in pyriform sinuses.Results:10 cases had recovered all function of larynx,7 cases had recovered partial function of larynx.These 17 patients were followed up for 1～8 years,1 case had tumor recurrence within 6 month and died after the second operation.3 cases were found cervical mass in 1.5～2 years after operation and survived with modified cervical radical dissection. The one who suffered from lung metastasis and the other one who suffered from mediastinum superior metastasis were dead.The 3 years and 5 years survial rates were 62.8% and 41% respectively.Conclusion:The combined application of split flap and ectopectoralis musculocutaneous flap in the resection of the hypopharyngeal cancer with the laryngeal reservation is feasible.

关 键 词：下咽肿瘤 喉功能 外科皮瓣 喉咽癌 治疗 

分 类 号：R739.65[医药卫生—肿瘤]