Stomal recurrence: salvage surgery and reconstruction utilizing microvascular free tissue transfer.

Head & Neck Pub Date : 2014-10-01 Epub Date: 2013-12-18 DOI:10.1002/hed.23468

Amy Pittman, Robert Lindau, Peter Andersen, Mark K Wax

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引用次数: 8

Abstract

Background: Stomal recurrence in patients after laryngectomy has a poor prognosis. Studies performed using sternal resection with pectoralis flap reconstruction report <25% 2-year survival. The purpose of this study was to ascertain whether the use of larger resection with free flap reconstruction improves survival.

Methods: Thirteen cases of stomal recurrence that underwent extended sternal resection and free flap reconstruction were identified and classified according to Sisson criteria. Postoperative morbidity, mortality, and survival were assessed.

Results: Median survival was 10 months in patients with Sisson types I and II, with 37.5% 1-year and 25% 2-year survival. Median survival was 6 months in patients with Sisson types III and IV, with 40% 1-year and 0% 2-year survival. There were 2 perioperative deaths and a major morbidity rate of 45%.

Conclusion: Salvage surgery using free flap reconstruction did not show improved survival rates compared with previously described techniques.

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吻合口复发:利用微血管游离组织移植进行挽救性手术和重建。

背景:喉切除术后造口复发预后较差。方法:对13例经扩大胸骨切除术和游离皮瓣重建的造口复发患者进行鉴定，并按Sisson标准进行分类。评估术后发病率、死亡率和生存率。结果:Sisson I型和II型患者的中位生存期为10个月，1年生存率为37.5%，2年生存率为25%。Sisson III型和IV型患者的中位生存期为6个月，1年生存率为40%，2年生存率为0%。围手术期死亡2例，主要发病率45%。结论:与先前描述的技术相比，使用游离皮瓣重建的挽救手术并没有显示出更高的存活率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Head & Neck

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