ABSTRACT
The aim of our research was to analyze general and local complications during the restoration-reconstruction operations in patients with epidermoid cancer on a lower lip. We have analyzed 61 patients' histories who were treated at the department of head and neck tumors of A. Gvamichava National Center of Oncology during 1990-2000. Based on the spread of the disease at the certain stage of treatment surgical operation becomes necessary that is broad excision of the tumor. Unfortunately it is impossible to restore the lip with the help of the local tissues that demands to perform restoration-reconstruction surgery with the use of rotated or free skin-muscular or mucilaginous-muscular scraps and consequently we considered it expedient to estimate functional and cosmetic efficiency of the used restoration-reconstruction surgery. The most attention was paid to analyze the local and general complication that might significantly influence cosmetic and functional results of the treatment. Based on our investigations it may be concluded that after the surgical treatment of the cancer of the lower lip the local complications is detected in 23,1%, among which the most frequent is secondary wound repair along with formation of oral fistula. After the performed restoration-reconstruction surgery the scrap necrosis was detected in 5 cases (8, 2%). The mentioned complication mostly was developed in patients for whom the rotated scrap was taken from upper lipt.
Subject(s)
Carcinoma, Squamous Cell/surgery , Lip Neoplasms/surgery , Lip/surgery , Plastic Surgery Procedures , Postoperative Complications/diagnosis , Female , Humans , Male , Postoperative Complications/pathologyABSTRACT
The supraglottic cancer is characterised by high incidence of regional metastasis significantly worsening the prognosis. Working out of an adequate regional control represents the one of the important problems. The aim of the study was the evaluation of pre-operative radiation therapy in 331 patients with N-negative supraglottic cancer. Three groups of patients were analyzed: I-radiation therapy/laryngectomy, II-laryngectomy/radiation therapy, III-only laryngectomy. It was found that the main prognostic factors of regional metastasis are: extension, differentiation, ulceration and growth pattern of tumor. The pre-operative radiation therapy is reasonable for effective regional control. The fact that the regional recurrence is developing faster in patients not conducted the radiation therapy at all is also indicating on the above-mentioned. Despite the fact, that the regional control is improving with pre-operative radiation, the overall survival of supraglottic cancer could not be regarded adequate, which requires the further study in terms of evaluation of preventive neck dissections with laryngectomy is this group of patients.
Subject(s)
Laryngeal Neoplasms/radiotherapy , Preoperative Care/methods , Disease Progression , Follow-Up Studies , Humans , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/surgery , Laryngectomy , Male , Neoplasm Staging , Prognosis , Retrospective StudiesABSTRACT
The article presents an experience with the treatment of patients with malignancy of the larynx, laryngopharynx and cervical part of the esophagus with a free autotransplant of the small intestine using a microsurgical technique for reestablishment of the arterial and venous blood circulation in the transplant. On the basis of the postmortem material the advantage of using the initial part of the jejunum were revealed. Experimental studies for the development of the microsurgery technique allowed the authors to propose some methodical means specially for the above operations. Eight operations were performed in the clinic with good functional results.
Subject(s)
Esophageal Neoplasms/surgery , Esophagoplasty/methods , Jejunum/transplantation , Esophageal Neoplasms/rehabilitation , Esophagus/blood supply , Humans , Jejunum/blood supply , Male , Middle Aged , Neck , Transplantation, Autologous , Vascular Surgical Procedures/methodsABSTRACT
A one-stage procedure to restore the cervical part of the esophagus and laryngopharynx included extended surgery for advanced cancer of the larynx and laryngopharynx and grafting a free revascularized small intestine segment using microvascular technique. Free small intestine transplant proved well-fed by sufficiently large branches of the external carotid artery, and normal venous drainage was retained. The transplant proved biologically best suitable for such type of plastic surgery. Treatment results should be considered promising.
