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目的 :研究如何在保留喉功能喉咽癌切除术后应用裂层皮片加胸大肌肌皮瓣整复组织缺损。方法 :总结 1988至 1998年 17例保留喉功能喉癌切除术后利用裂层皮片加胸大肌肌皮瓣整复组织缺损的临床资料。肿瘤原发于咽后壁区 6例 ,原发于梨状窝区 11例。结果 :10例恢复了喉的全部功能 ,7例恢复了喉的部分功能。随访 1～ 8年。 17例中半年内复发 1例 ,再次手术后 1年肿瘤再次复发死亡。 3例术后 1 5～ 2年颈部淋巴结转移 ,经行改良根治性颈廓清术现健在。 1例上纵隔转移 ,1例肺转移 ,经保守治疗无效死亡。 3年生存率为 62 8%。 5年生存率为 4 1 0 %。结论 :裂层皮片加胸大肌肌皮瓣是保留喉功能喉咽癌切除术后整复组织缺损的理想材料
OBJECTIVE: To study how to repair the tissue defect by using split skin flap and pectoralis major myocutaneous flap after preserving the laryngeal function. Methods: From 1988 to 1998, 17 cases of laryngeal laryngeal carcinoma with laryngeal carcinoma retained laminectomy and pectoralis major myocutaneous flap repair of tissue defects after the clinical data. Tumor origin in the posterior pharyngeal wall area in 6 cases, origin in the piriform area of 11 cases. Results: All of the laryngeal functions were restored in 10 cases and partial laryngectomy was restored in 7 cases. Follow-up 1 ~ 8 years. One case relapsed within six months in 17 cases, and the tumor recurred again one year after the operation. Three cases of cervical lymph node metastasis after 1 5 ~ 2 years, improved by radical neck dissection are now alive. 1 case of mediastinal metastasis, 1 case of lung metastasis, died of conservative treatment ineffective. The 3-year survival rate was 62.8%. The 5-year survival rate was 41.0%. Conclusion: The split skin flap and the pectoralis major myocutaneous flap are the ideal materials to preserve the tissue defect after laryngecto-pharyngeal carcinoma resection