改良颏下岛状皮瓣在下咽癌喉功能保留手术中的应用  

Application of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery

作　　者：谭平清[1,2] 陈杰 黄文孝[1,2] 包荣华 李晋芸[1,2] 王俊琦 谢李[1,2] 钟外生 张海林[1,2] 

机构地区：[1]湖南省肿瘤医院 [2]中南大学湘雅医学院附属肿瘤医院头颈外科,长沙410006

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第15期1342-1345,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：湖南省科技厅社会发展支撑计划(No:2013SK3203)

摘　　要：目的:评估改良颏下岛状皮瓣在下咽癌喉功能保留手术中的应用及其临床效果。方法:回顾分析38例应用颏下岛状皮瓣修复保留喉功能的下咽癌患者的临床资料,通过对颏下皮瓣的血管蒂的设计、下咽癌切除后喉、下咽功能的重建方式以及颏下皮瓣切取后颈部伤口的关闭等方面进行改良和应用,并综合评估改良颏下岛状皮瓣应用于下咽癌喉功能保留手术患者的效果及预后。结果:38例患者术后颏下皮瓣均成活。随访期内18例死亡,其中7例死于第二原发癌,分别为4例食管癌,1例软腭癌,2例鼻咽癌;5例死于颈部或咽旁淋巴结复发;2例死于肝转移;4例死于肺转移。总体5年生存率52.6%。结论:改良颏下岛状皮瓣应用于下咽癌保留喉功能手术缺损重建具有成功率高、安全、简便及疗效良好等优点,值得临床推广应用。Objective：This study aimd to evaluate the application and clinical effect of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery.Method：A retrospective review of clinical data was performed on 38 patients of hypopharyngeal cancer reserved laryngeal function using sumental island flaps,by the way of improving in design of vascular pedicle,reconstructive mode of laryngeal and hypopharyngeal function and closing of wound of neck following hypopharyngeal cancer resection.Meanwhile,the effect and prognosis was comprehensively assessed on patients with hypopharyngeal cancer reserved laryngeal function using improved submental island flaps.Result：The submental flaps kept alive in all 38 cases.During the follow-up period,18 cases were dead,and of them,7cases died of the second primary carcinoma,included 4cases of esophagus cancer,1case of cancer of soft palate,2cases of nasopharyngeal carcinoma;and 5cases died of cervical or parapharyngeal lymph nodes recurrence;2cases died of hepatic metastasis;and 4cases died of pulmonary metastasis.The overall 5-years survival rate was 52.6%.Conclusion：Improved submental island flap repairing postoperative defect of hypopharyngeal cancer reserved laryngeal function has many advantages including higher success rate,more security,easy and simple to operate as well as good clinical effects,and is worth to widespread using.

关 键 词：颏下皮瓣 下咽肿瘤 修复外科手术 

分 类 号：R739.62[医药卫生—肿瘤]