A study of 16 cases on the island pectoralis major muscle flap in repair for the defects after the laryngeal function reserved operation of hypopharyngeal carcinoma
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摘要: 目的: 探讨带蒂岛状胸大肌肌皮瓣在保留喉功能的下咽癌切除手术缺损的Ⅰ期修复中的应用。方法: 回顾性分析16例下咽癌手术缺损采用带蒂岛状胸大肌肌皮瓣Ⅰ期修复的患者资料,其中原发灶位于梨状窝14例,咽后壁2例。结果: 16例胸大肌肌皮瓣全部成活,2例出现咽瘘,经换药后痊愈。14例于1~3个月拔除气管套管,2例带管生存,所有患者外观及功能上效果满意。16例中,2例存活3年半,死于肺转移;2例存活4年,分别死于局部复发和心脏病;1例存活4年半,死于肺转移;其余11例仍在随访中。结论: 带蒂岛状胸大肌肌皮瓣在保留喉功能的下咽癌手术缺损修复中的应用是安全有效的。Abstract: Objective: To explore the application about island pectoralis major muscle flap in repair for the defects after the laryngeal function reserved operation of hypopharyngeal carcinoma.Method: A retrospective analysis about 16 patients who underwent hypopharyngeal carcinoma surgery using pedicle island pectoralis major myocutaneous flap to repair, including 14 cases whose primary tumors located in the piriform fossa, and 2 cases in pharynx posterior wall.Result: All 16 cases' pectoralis major muscle flap survived, 2 of patient appeared to have a pharyngeal fistula, but recovered after transition. Of the 16 cases, 14 cases were removed the trachea tube in 1-3 months, 2 cases survive with tube, and all patients were satisfied with their appearance and the function. In 16 cases, 2 of them survived 3 and a half years, died of lung metastasis; 2 cases survived for four years, 1 died of local recurrence of tumor and another died of heart disease; 1 survived for four and a half years and died of lung metastasis; the remaining 11 cases were still in follow-up.Conclusion: The application in the surgical defect repair of pharyngeal carcinoma with pedicle island pectoralis major myocutaneous flap is safe and effective.
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