晚期咽喉癌之重建手術－咽喉近全切除術與胸大肌肌皮瓣之應用

Reconstructive Surgery for Late-stage Laryngopharyngeal Carcinoma - Near-total Laryngopharyngectomy with Pectoralis Major Myocutaneous Flap

蘇志英(Chih-Ying Su)

《中華民國耳鼻喉科醫學會雜誌》 28卷2期 (1993/04) Pp. 116-122

https://doi.org/10.6286/1993.28.2.116

摘要

咽喉近全切除手術法是治療可切除的T3、T4晚期咽喉癌的方法之一。其理念，乃是以一次手術完成腫瘤摘除之同時，著眼於器官及其機能之保存或重建。近5年中，以此法共治療31例T3、T4之咽喉癌患者。本文針對22例追蹤期超過6個月者提出報告。其中6例喉癌病人施行喉近全切除術；11例下咽癌與1例喉癌患者施行喉近全切除與咽部分切除術；至於4例廣泛侵犯之下咽癌病例，則施行咽喉全切除術合併胸大肌肌皮瓣重建術。追蹤迄今，合併症、腫瘤復發或轉移之病例並不多見。且大多數患者術後之分流發聲和吞嚥功能良好。

關鍵字

喉近全切除術 ； 咽喉近全切除術 ； 胸大肌肌皮瓣

並列摘要

For a resectabe T3, T4 laryngeal or pharyngeal carcinoma, there has been a tendency to perform an aggressive resection of the organs, the larynx and/or pharynx, instead of mere ablation of the tumor. In the past decade, near-total operation had been proven to be suitable for T3 and T4 laryngopharyngeal cancer patients if the contralateral hemilarynx, the pyriform sinus, the interarytenoid area and the midpostcricoid region are free of tumor invasion. This report described the principles and the results of near-total operation in 22 cases of laryngeal or pharyngeal carcinoma. Special emphasis was laid on the technique and the outcome of near-total laryngopharyngectomy with pectoralis major myocutaneous flap in four patients with advanced hypopharyngeal carcinoma. Postoperatively, all four patients were able to make fluent shunt speech and to swallow a regular diet.

並列關鍵字

Near-total laryngectomy ； near-total laryngopharyngectomy ； pectoralis major myocuta-neous flap