진행된 하인두암 환자의 수술적 절제 후  재건시 이용된 위간치술의 유용성

이진우; 오세준; 이종길; 이병주; 이진춘; 왕수건

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자료유형: 학술저널

저자정보: 이진우 오세준 이종길 이병주 이진춘 왕수건

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제52권 제1호

발행연도: 2009.1

수록면: 57 - 61 (5page)

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Background and Objectives：Various methods of reconstruction have been used after resection of hypopharynx. This study is aimed to evaluate the results and usefullness of gastric pull-up reconstruction. Subjects and Method：The clinical data of 12 hypopharyngeal cancer patients, who were treated with gastric pull-up primary surgery (9 patients, 75.0%) or with salvage surgery (3 patients, 25.0%) after radiotherapy with or without chemotherapy, were studiedfrom 1987 to 2002. This study was a retrospective review of 12 patients (8 males and 4 females, mean age 57.3 years). Results：Nine (75.0%) patients were stage IV and 3 (25.0%) patients were stage III. Total pharyngolaryngoesophagectomies were performed and reconstructed by gastric pullup. Five year survival rate was 57.7%. Five patients died of locoregional recurrence or distant metastasis and 3 patients were lost. The mean time forthe initiation of oral feeding was 32.2 days (range 23 to 58 days). Postoperative complications were hemothorax (1), fistula (2), stenosis (1), hypocalcemia (1), and regurgitation (2). There was no flap failure. Conclusion：Although gastric pull-up after resection of advanced hypopharyngeal and cervical esophageal lesions has morbidity and mortality of a combined abdominal, thoracic and cervical operation, flap failure rate is relatively low compared with free flap reconstructions such as jejunal free flap, myocutaneous free flap (radial forearm free flap or anterolateral thigh free flap). Gastric transposition constitutes relatively safe and effective method of restoring the continuity of the upper digestive tract following surgery of extensive carcinoma of the hypopharynx, larynx, and cervical esophagus.

#하인두암·위간치술 #Hypopharyngeal cancer·Gastric pull-up

참고문헌 (20)

참고문헌 신청

Anthony JP / 1994 / Pharyngoesophageal reconstruction using the tubed free radial forearm flap / Clin Plast Surg 21 (1) : 137 ~ 147

Ayshford CA / 1999 / Reconstructive techniques currently used following resection of hypopharyngeal carcinoma / J Laryngol Otol 113 (2) : 145 ~ 148

Baek CH / 2002 / Pharyngoesophageal reconstruction with lateral thigh free flap / Head Neck 24 (11) : 975 ~ 981

Cahow CE / 1994 / Gastric pull-up reconstruction for pharyngolaryngo-esophagectomy / Arch Surg 129 (4) : 425 ~ 430

Clark JR / 2006 / Morbidity after flap reconstruction of hypopharyngeal defects / Laryngoscope 116 (2) : 173 ~ 181

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