Repair of the surgical defect for stomal recurrence after total laryngectomy / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To explore the indication and effect of primary repair of the defects for stomal recurrence after total laryngectomy. METHODS A total of 18 cases with stomal recurrence after total laryngectomy were performed operation.The defect of hypopharynx and cervical oesophagus was repaired with free forearm flap (n=5),free jejunual interposition(n=3),pectoralis major myocutaneous flap (n=1)and pharyngogastric anastomosis(n=2).The defect of skin was repaired with pectoralis major myocutaneous flap.RESULTS All pectoralis major myocutaneous flaps were viable. Pharyngeal fistula occurred in 4 cases,one of whom had been performed free jejunual interposition,2 had been performed free forearm flap,and one with fistula bleeding had been performed pharyngogastric anastomosis.All cases could swallow after operation. During follow-up for 6 to 74 months,swallow obstruction occurred in 3 cases.CONCLUSION The methods of repair for surgical defect of stomal recurrence after total laryngectomy should depend on the bound of stomal recurrence and therapeutic procedure of primary tumor.