하인두암에서 요골측 전박유리피판을 이용한 하인두 및 경부식도 재건술

Abstract

The reconstructive methods for hypopharynx and cervical esophagus after wide resection of hypopharyneal cancer include various myocutaneous flap, usage of digestive tracts such as pharyngogastric anastomosis and free jejunal graft, and radial forearm free flap. The foreatm free flap is thin and pliable so that it can be easily fabricated as tube. And it also affords a relatively long and large vascular pedicle which facilitates the microvascular anastomosis much easier. Between January, 1993 and December, 1994, seven cases of hypopharyngeal cancer were reconstructed using radial forearm free flap at Severance Hospital. All the flaps were used simultaneously with ablative oncologic surgery. Four cases were reconstructed in a completely tubed fashion, and three cases were partially tubed. The flaps successfully survived in all cases. Delayed healing with fistula formation was encountered in 3 cases, of which 2 cases were spontaneously healed up. One case of fistula was healed up after secondary surgical procedure. Oral feeding was well tolerated in all the living patients. We concluded that the forearm free flap is an useful method in a situation requiring reconstruction of hypopharynx and cervical esophagus.