口腔咽頭と食道の同時性重複癌に対する再建手術の工夫

DOI 被引用文献1件 参考文献14件

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  • SURGICAL TREATMENTS FOR SYNCHRONOUS DOUBLE PRIMARY CANCER OF THE HEAD, NECK AND ESOPHAGUS REGION

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We report 5 types of reconstruction method performed for 7 patients suffering from synchronous double primary cancer of the head, neck and esophagus region. For 2 patients who required resection of their oral floor and the thoracic esophagus, we chose a free jejunal patch graft transfer for the repair of the intra-oral mucosal defect and a simultaneous resection of esophageal cancer. In 3 of 4 patients following a complete resection of the hypopharynx and esophagus, a reversed technique of lesser curvature of the stomach was adopted for repairing the digestive tract. A combined reconstruction was performed in another patient by using a free jejunal graft and elevated gastric tube through posterior mediastinum route. For the patient who desired voice restoration after total laryngectomy, we chose a combined usage of a free ileocecal segment and gastric tube after the surgical resection of double primary cancer of the hypopharyngeal and esophageal region. In conclusion from our clinical experiences, we recommend the use of a free jejunal patch graft for reconstruction of the oral floor defect instead of using the radial forearm flap. The jejunal patch graft does not hinder tongue mobility and can prevent post-radiation xerostomia after surgery. A reversed technique of lesser curvature of the stomach is also recommended to repair the digestive tract after laryngo-pharyngectomy with total esophagectomy. This technique makes it possible to reconstruct the defective region from head through abdomen at the same time, and to shorten the operation time. For the patient who requests voice restoration after laryngectomy, a free ileocecal graft transfer could be adopted and this method is available even in the patient who has to have esophagectomy performed simultaneously.

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  • 頭頸部腫瘍

    頭頸部腫瘍 29 (1), 118-123, 2003

    日本頭頸部癌学会

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