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하인두 및 경부식도 결손의 재건 : 재건술의 선택

Other Titles
 Reconstruction of Hypopharynx and Cervical Esophagus : Choice of Flap 
 최은창  ;  이세영  ;  정태영  ;  김세헌  ;  김영호  ;  유대현  ;  김충배 
 Korean Journal of Head & Neck Oncology (대한두경부종양학회지), Vol.16(1) : 26-32, 2000 
Journal Title
Korean Journal of Head & Neck Oncology(대한두경부종양학회지)
Issue Date
Hypopharyngeal reconstruction ; Complication ; Gastric pull-up ; Free jejunal transfer ; Forearm free flap
Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Heon(김세헌)
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