RESUMO
In advanced hypopharyngeal carcinoma, the tumor may involve the entire hypopharyngeal mucosa and the larynx. After total laryngohypopharyngectomy is done, reconstruction of the circumferential defect of the hypopharynx is a challenge. We described our results of using a myomucosal tongue flap with dermal or skin graft (MTF) in 8 patients and using a tubed pectoralis major myocutaneous flap (TPMF) in 10 patients to reconstruct the total hypopharynx. There was no operative mortality. Fistula formation occurred in 3 patients of the MTF group and 4 in the TPMF group but all had spontaneous healing after conservative treatment. One in the MTF group and 4 in the TPMF group had stenosis of the anastomotic sites. Almost all responded well with periodic dilatation. Only one patient in the TPMF group who had been previously irradiated required gastrostomy for feeding. The 5-year actuarial survival rate of our patients was 32 per cent. These results show that total hypopharynx can be reconstructed with the above noted procedures. The survival rate is good, the morbidity rate is acceptable, and the perioperative mortality rate is zero.
Assuntos
Análise Atuarial , Idoso , Anastomose Cirúrgica , Feminino , Humanos , Neoplasias Hipofaríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Músculos Peitorais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Transplante de Pele , Retalhos Cirúrgicos , Língua/cirurgia , Resultado do TratamentoRESUMO
A retrospective study of 310 patients with foreign bodies in the esophagus was analyzed. The most common age of the esophageal foreign body patients was between 0 to 9 years old (32.6%), and a coin was the most common foreign object in children. Bone, fish bone and bolus of meat were found commonly in adults, while dentures were encountered in the old age group. History of foreign body ingestion, dysphagia and odynophagia were usually presented by the patients. Roentgenographic study was useful in diagnosis and plan of management. Rigid esophagoscopy under general anesthesia is recommended in all patients with suspected history of foreign body, even though plain films of the chest and neck failed to demonstrate any significant findings. Complications can be reduced if the treatment is conducted within 24 hours of foreign body impaction.