游离空肠移植术后再手术时对血管蒂的保护

目的 观察全喉全下咽切除术后空肠游离移植术二次手术时同时保留动静脉血管蒂或仅保留动脉血管带时对移植组织的影响.方法 回顾分析2002年1月-2009年12月4例下咽癌行全喉全下咽切除术空肠游离移植术术后8～18个月因颈鄙转移灶出现而需再行手术患者的临床资料,其中3例行根治性颈清扫,1例行局部包块扩大切除术.2例同时保留...

Protection of the Vascular Pedicles during Re-operation after Free Jejunal Transplantation

Objective To observe the effect of keeping arteriovenous or venous pedicles during the second free jejunal transplantation after total laryngopharyngectomy on the transplanted tissues.Methods From January 2002 to December 2009,four patients underwent total laryngopharyngectomy and free jejunal.But 8-18 months later,the patients underwent another operation because of recurrent metastatic mass in the ipsilateral neck side of anastomosis;in whom three underwent radical neck dissection and one underwent local enlarged mass resection.In the four patients,two had arteriovenous pedicles remained and another two kept only venous pedicles.Results All of the four patients experienced first-stage healing.The deglutitive function in the two patients who had received the arteriovenous pedicles preservation didn’t differ much from that before the operation.While vague anguish in the anterior region of the neck,weak peristalsis of the transplanted jejunum,a little discomfort and slow swallowing were found in another two patients.Conclusion Keeping vascular pedicles during re-operation helps make the activity of the transplanted jejunum.