Volume 19 Issue 3
Mar.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(3): 351-353,386
LIU Shen-cheng, CUI Yi-xuan, ZHAO Bao, ZHOU Lan-zhu, WU Jun, WANG Wen-zhong. Application of residual laryngeal mucosa flap in surgical repair of hypopharyngeal carcinoma[J]. Chinese Journal of General Practice, 2021, 19(3): 351-353,386. doi: 10.16766/j.cnki.issn.1674-4152.001807
Citation: LIU Shen-cheng, CUI Yi-xuan, ZHAO Bao, ZHOU Lan-zhu, WU Jun, WANG Wen-zhong. Application of residual laryngeal mucosa flap in surgical repair of hypopharyngeal carcinoma[J]. Chinese Journal of General Practice, 2021, 19(3): 351-353,386. doi: 10.16766/j.cnki.issn.1674-4152.001807
shu

Application of residual laryngeal mucosa flap in surgical repair of hypopharyngeal carcinoma

doi: 10.16766/j.cnki.issn.1674-4152.001807

  • Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 81904142

 KJ2019A0293

 2019byyfyyq03

 BYTM2019010

  • Received Date: 2020-08-27
    Available Online: 2022-02-19
    Abstract
  •   Objective   To explore the application of residual laryngeal mucosa flap in surgical repair of hypopharyngeal carcinoma.   Methods   Total 48 patients with hypopharyngeal cancer who underwent hypopharyngeal defect repair with residual laryngeal mucosal flap in the Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Bengbu Medical College from September 2015 to September 2017were collected. The TNM stages of 48 patients were T2N0M0 8 cases, T2N1M0 7 cases, T2N2M0 7 cases, T3N0M0 10 cases, T3N1M0 9 cases, T3N2M0 6 cases and T4N2M0 1 cases. According to the primary location of the tumor, the surgical approaches were selected: epiglottis valley, lateral wall or tip of pyriform fossa entering the pharyngeal cavity. The resection range was 1.5-2.0 cm from the tumor. The cutting edge was quickly frozen and the residual laryngeal mucosal flap was used to repair the hypopharyngeal defect. Evaluate the changes of patients' condition and physical condition, and receive radiotherapy or chemotherapy one month after operation.   Results   All 48 patients recovered normal swallowing function in a short time. Local infection and pharyngeal fistula were found in 3 patients 6 days after operation. The pharyngeal fistula was less than 2 cm, accounting for 6.25% (3/48), and healed within 2 weeks after local dressing change. Anastomotic stenosis occurred in 2 patients (6.25%, 2/32) after operation, and improved after corresponding expansion. Among them, 16 patients underwent total laryngectomy and breathed smoothly after operation. Tracheal cannula was removed in 28 patients within 3 months after operation, and extubation rate was 94% (30/32) in 2 patients 6 months after operation. The laryngeal cavity of 2 patients was narrow after operation, which made it impossible to extubate. Local recurrence + cervical metastasis + distant metastasis (lung metastasis) occurred in 2 cases within 3 years. Local recurrence + esophageal metastasis occurred in 1 case within 3 years. One patient was depressed (self-catheter removal), and 5 patients lost follow-up. The 3-year survival rate was 81.3% (39/48).   Conclusion   Repairing hypopharyngeal defect after partial hypopharyngeal cancer resection with residual laryngeal mucosa flap has the advantages of taking materials nearby, not increasing incision, less trauma, strong anti-infection ability, easy survival and relatively few complications.

     

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