遊離腸管移植による咽喉食摘後の食道・音声同時再建

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タイトル別名
  • Reconstruction of neopharyngoesophagus and phonation following laryngopharyngoesophagectomy using a free intestinal gaaft.

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Continuity of the pharynx and the upper esophagus following cancer extirpation can be restored with minimum morbidity by means of transfeming a segment of intestine. Voice rehabilitation in this group patients, on the hand, can be difficult. By modifying an intestinal graft used for pharyngoesophageal reconstruction, we are able to provide 25 patients with voice production.<br>Group I: The neopharyngoesophagus and tracheo-neoesophageal shunt were constructed in 8 individuals using a ileocecal intestine.<br>Group II: The neopharyngoesophagus and siphon-like tracheo-neoesophageal shunt were restored in 5 individuals using a single vascular pedicled jejunum which was divided into two segments.<br>Group III: In 12 individuals, after divided ajejunm into two segments, the constructed neopharyngoesophagus was anastomosed in a side-to-end fashion to the fabricated shunt using the other segment of jejunum which was named as an “Elephant shunt” because of its appearance resembling the nose of an elephant.<br>Voice rehabilitation in those patients who had laryngo-pharyngoesophagectomy can be achieved through these reconstructive procedures. Otherwise, the patients in Group III were judged to be supperiorin easy speech and minimized donor site morbidity than the patients in other groups.

収録刊行物

  • 頭頸部腫瘍

    頭頸部腫瘍 23 (3), 547-552, 1997

    日本頭頸部癌学会

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