喉切除术和放疗后的咽喉瘤重建:回顾性研究与文献综述。

{"title":"喉切除术和放疗后的咽喉瘤重建:回顾性研究与文献综述。","authors":"","doi":"10.1016/j.bjps.2024.10.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The occurrence of pharyngocutaneous fistula or pharyngostoma after oncologic head and neck surgery is a serious complication. It is the most common complication after major hypopharyngeal and laryngeal ablative surgery.</div></div><div><h3>Aim</h3><div>The purpose of this study is to review the surgical approach and evaluate the results regarding reconstruction methods of pharyngostoma, caused after laryngectomy and radiotherapy.</div></div><div><h3>Patients and methods</h3><div>The total number of patients is 15. Pharyngostoma caused swallowing difficulties, as well as frequent aspiration pneumonia. The intervention interval from laryngectomy to pharyngeal reconstruction varied between one and three years, depending on the severity of symptoms and after the complete failure of conservative rehabilitation methods. Pharyngostoma reconstruction was performed mainly with pectoralis major myocutaneous flap in 11 cases. The radial forearm free flap and the anterolateral thigh free flap were also used in the remaining four cases.</div></div><div><h3>Results</h3><div>The post-operative course was uncomplicated, and in most cases, the feeding with soft food started after a barium meal between 15 and 20 days post-operatively. Complications include wound dehiscence and leak treated conservatively and one case of carotid rupture.</div></div><div><h3>Conclusions</h3><div>The gold standard for pharyngostoma reconstruction, after laryngectomy and cervical radiotherapy, remains the use of pectoralis major myocutaneous flap. In cases of extensive neck radionecrosis, free flaps are preferable. Reliable and stable cover of the large vessels of the neck, along with the reconstruction of the digestive tract and the restoration of swallowing function are issues that are analysed in correlation with the avoidance of stenosis and swallowing difficulties.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pharyngostoma reconstruction after laryngectomy and radiotherapy: A retrospective study and literature review\",\"authors\":\"\",\"doi\":\"10.1016/j.bjps.2024.10.019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The occurrence of pharyngocutaneous fistula or pharyngostoma after oncologic head and neck surgery is a serious complication. It is the most common complication after major hypopharyngeal and laryngeal ablative surgery.</div></div><div><h3>Aim</h3><div>The purpose of this study is to review the surgical approach and evaluate the results regarding reconstruction methods of pharyngostoma, caused after laryngectomy and radiotherapy.</div></div><div><h3>Patients and methods</h3><div>The total number of patients is 15. Pharyngostoma caused swallowing difficulties, as well as frequent aspiration pneumonia. The intervention interval from laryngectomy to pharyngeal reconstruction varied between one and three years, depending on the severity of symptoms and after the complete failure of conservative rehabilitation methods. Pharyngostoma reconstruction was performed mainly with pectoralis major myocutaneous flap in 11 cases. The radial forearm free flap and the anterolateral thigh free flap were also used in the remaining four cases.</div></div><div><h3>Results</h3><div>The post-operative course was uncomplicated, and in most cases, the feeding with soft food started after a barium meal between 15 and 20 days post-operatively. Complications include wound dehiscence and leak treated conservatively and one case of carotid rupture.</div></div><div><h3>Conclusions</h3><div>The gold standard for pharyngostoma reconstruction, after laryngectomy and cervical radiotherapy, remains the use of pectoralis major myocutaneous flap. In cases of extensive neck radionecrosis, free flaps are preferable. Reliable and stable cover of the large vessels of the neck, along with the reconstruction of the digestive tract and the restoration of swallowing function are issues that are analysed in correlation with the avoidance of stenosis and swallowing difficulties.</div></div>\",\"PeriodicalId\":50084,\"journal\":{\"name\":\"Journal of Plastic Reconstructive and Aesthetic Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Plastic Reconstructive and Aesthetic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1748681524006636\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Plastic Reconstructive and Aesthetic Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1748681524006636","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

背景:头颈部肿瘤手术后出现咽瘘或咽口瘤是一种严重的并发症。目的:本研究旨在回顾喉切除术和放疗后引起的咽口瘘的手术方法,并评估重建方法的效果:患者和方法:患者总数为 15 人。咽喉瘤导致吞咽困难,并经常引发吸入性肺炎。从喉切除术到咽部重建的干预间隔时间为一到三年不等,这取决于症状的严重程度以及保守康复方法完全失败后的情况。11例患者主要使用胸大肌肌皮瓣进行咽喉重建。其余四例也使用了前臂桡侧游离皮瓣和大腿前外侧游离皮瓣:结果:术后过程并不复杂,大多数病例在术后 15-20 天服用钡餐后开始进食软食。并发症包括保守治疗的伤口裂开和渗漏,以及一例颈动脉破裂:结论:喉切除术和颈部放疗后,咽喉瘤重建的金标准仍然是使用胸大肌皮瓣。在颈部广泛放射性坏死的病例中,游离皮瓣更为可取。颈部大血管的可靠和稳定覆盖、消化道的重建以及吞咽功能的恢复,都是与避免狭窄和吞咽困难相关的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Pharyngostoma reconstruction after laryngectomy and radiotherapy: A retrospective study and literature review

Background

The occurrence of pharyngocutaneous fistula or pharyngostoma after oncologic head and neck surgery is a serious complication. It is the most common complication after major hypopharyngeal and laryngeal ablative surgery.

Aim

The purpose of this study is to review the surgical approach and evaluate the results regarding reconstruction methods of pharyngostoma, caused after laryngectomy and radiotherapy.

Patients and methods

The total number of patients is 15. Pharyngostoma caused swallowing difficulties, as well as frequent aspiration pneumonia. The intervention interval from laryngectomy to pharyngeal reconstruction varied between one and three years, depending on the severity of symptoms and after the complete failure of conservative rehabilitation methods. Pharyngostoma reconstruction was performed mainly with pectoralis major myocutaneous flap in 11 cases. The radial forearm free flap and the anterolateral thigh free flap were also used in the remaining four cases.

Results

The post-operative course was uncomplicated, and in most cases, the feeding with soft food started after a barium meal between 15 and 20 days post-operatively. Complications include wound dehiscence and leak treated conservatively and one case of carotid rupture.

Conclusions

The gold standard for pharyngostoma reconstruction, after laryngectomy and cervical radiotherapy, remains the use of pectoralis major myocutaneous flap. In cases of extensive neck radionecrosis, free flaps are preferable. Reliable and stable cover of the large vessels of the neck, along with the reconstruction of the digestive tract and the restoration of swallowing function are issues that are analysed in correlation with the avoidance of stenosis and swallowing difficulties.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.10
自引率
11.10%
发文量
578
审稿时长
3.5 months
期刊介绍: JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.
期刊最新文献
Editorial Board The impact of cosmetic tourism across one year on an NHS breast surgery unit The roles of extracranial intravascular lesion, vasodilation-induced neural entrapment, and arteriolysis in migraine treatment Nail reconstruction using an osteo-onychocutaneous flap with the dorsal digital artery of the hallux as the pedicle: Techniques and anatomical insights Reduction mammaplasty relieves depression in women with macromastia: A systematic review
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1