胸大肌肌皮瓣修复咽喉部恶性肿瘤术后组织缺损的临床分析

目的 探讨胸大肌肌皮瓣在咽喉部肿瘤手术中的应用方法及临床效果.方法 23例咽喉部恶性肿瘤患者,用胸大肌肌皮瓣对术中组织缺损进行修复.结果 23例患者中,肌皮瓣坏死1例,咽瘘4例,下咽食管狭窄1例；除1例因咽瘘颈部感染致颈部动脉破例死亡,1例下咽食管狭窄,带胃管出院外,其余患者均恢复吞咽功能.结论 胸大肌肌皮瓣血供可靠,组织容量大,在咽喉部肿瘤手术中应用,可以提高患者存活率及术后生活质量.

Cfinical analysis of pectoralis major myocutaneous flap for reconstruction of tissue defects after pharyngo. laryngeal cancer surgery

Objective To explore the methods and effects of pectoralis major myocutaneous flap in pharyngolaryngeal cancer surgery. Methods Twentythree cases of pharyngolmyngeal cancer patients were enrolled. The surgical procedure was decided on pathologic conditions. Meanwhile the surgical defects were repaired by pectoralis major myocutaneous flap. Results Flap necrosis occured in 1 case, pharyngeal fistula occured in 4 cases, 1 case had hypopharynx esophageal stenosis except for pharyngeal fistula in 1 patient with carotid artery rupture caused by infection exception dead. 1 case had hypopharynx esophageal stenosis with a gastric tube and was discharged. The remaining patients recovered with swallowing function. Conclusions The blood supply of pectoralis major myocuta neous flap is reliable and the tissue volume is enough for reconstruction. It can improve patient survival and postop erative quality of life in the application of pharyngolaryngeal cancer surgery.