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自1986年3月～1995年5月,我院头颈外科治疗下咽及颈段食管癌119例(122次手术),其中应用岛状胸大肌肌皮瓣85例,非开胸食管内翻拔脱咽胃吻合术(咽胃吻合术)25例,游离空肠4例,前臂游离皮瓣3例,带血管蒂的结肠2例。游离空肠及前臂游离皮瓣的病例各有1例失败(术后再次应用胸大肌肌皮瓣修复)。另外1例咽胃吻合术病人在颈部胃壁发生 大面积坏死,形成胃壁气管瘘感染肺炎后死亡。成功的病例术后二周内恢复经口进食,钡餐透视显示吻合通畅。成功率:97.6％(116/119),一年生存率:81.7％(89/109),三年生存率:55.3％(31/55),五年生存率:31.6％(6/19)。
From March 1986 to May 1995, 119 cases (122 operations) of hypopharyngeal and cervical esophageal cancer were treated with head and neck surgery in our hospital. Among them, 85 cases of island-like pectoralis major myocutaneous flaps were used, and non-open-thoracic esophageal inversion was performed. Twenty-five patients underwent pharyngeal anastomosis (pharyngeal anastomosis), four patients were free jejunum, three patients had forearm free flaps, and two patients had vascular pedicled colon. One case of free jejunum and forearm free flaps failed (after reoperation of pectoralis major myocutaneous flap). In another patient with pharyngeal anastomosis, a large area of necrosis occurred in the stomach wall of the neck, which caused the stomach wall trachea and died of pneumonia. Successful cases resumed oral feeding within two weeks after surgery, and barium meal showed an unobstructed anastomosis. Success rate: 97.6% (116/119), one-year survival rate: 81.7% (89/109), three-year survival rate: 55.3% (31/55), and five-year survival rate: 31.6% (6/19).