足量放疗或化疗后游离空肠Ⅰ期重建咽喉颈段食管缺损的临床应用  

The clinical application of adequate radiotherapy or free jejunal stage reconstruction of laryngopharyngeal esophageal defects after chemotherapy

作　　者：王玲[1] 殷文斌[1] 李会政[1] Wang Ling;Yin Wenbin;Li Huizheng(Department of Otolaryngology Head and Neck Surgery, Dalian Friendship Hospital, Dalian, Liaoning, 116000, China)

机构地区：[1]大连市友谊医院耳鼻咽喉头颈外科,辽宁大连116000

出　　处：《当代医学》2019年第7期77-80,共4页Contemporary Medicine

摘　　要：目的探讨足量放疗或化疗后游离空肠Ⅰ期重建咽喉及颈段食管缺损的临床应用。方法回顾性分析2011年11月至2017年4月6例术前行足量放疗或化疗后于本院行喉咽或颈段食管肿瘤切除并游离空肠Ⅰ期重建缺损的病例。总结手术适应证的选择、手术方法及手术效果。结果 6例患者移植游离空肠全部存活,成活率100%,无吻合口狭窄,吻合口瘘1例,发生率16.67%。6例患者最长随访时间40个月,最短17 d。围手术期死亡1例,发生率16.67%,1年死亡率33.3%,3年死亡率50%。结论术前足量放疗及化疗会损伤血管内膜,易造成血管闭塞及周围组织损伤,尤其是近期行放化疗者,挽救性手术围手术期风险较大,需谨慎选择。Objective To explore the clinical application of radiotherapy an of adequate radiotherapy or post-chemotherapy free jejunum reconstruction for the reconstruction of laryngopharyngeal and cervical esophageal defects. Methods From November 2011 to April 2017, 6 cases of Laryngopharynx or cervical esophageal neoplasms were treated with full dose of radiotherapy or chemotherapy in our hospital. The reconstruction of the free jejunal segment was performed in our hospital. To summarize the indications of surgical indications, surgical methods, perioperative management and surgical results. Results In 6 patients, free jejunum survived, the survival rate was 100%, no anastomotic stenosis and anastomotic fistula, the incidence was 16.67%. The maximum follow-up time was 40 months and 17 days in 6 patients. The incidence of perioperative death was 16.67%, One year' s death rate was 33.3%, and three year' s death rate was 50%. Conclusion Adequate preoperative radiotherapy and chemotherapy can damage of vascular intima, easy cause vascular occlusion and surrounding tissue damage, especially recent radiation and chemotherapy patients, save surgical perioperative risk, need to be careful to choose.

关 键 词：喉咽颈段食管缺损 游离空肠修复 放化疗 存活率 并发症 

分 类 号：R730.5[医药卫生—肿瘤]