Clinical Study On Repair Of Hypopharyngeal And Esophageal Defects With Residual Laryngeal Tracheal Composite Tissue Flap

Objectivet:To summarize and analyze the comprehensive treatment of hypopharyngeal carcinoma and the methods of repairing tissue defect after surgical resection.Combined with clinical practice,the advantages and disadvantages of the method for repairing tissue defects after surgical resection of hypopharyngeal carcinoma were compared and analyzed.The application value of residual laryngotracheal flap repair was explored.Methods : A total of 42 patients who had undergone surgical treatment in our department between September 2015 and December 2017,and were unable to maintain laryngeal function were selected.At the same time after the operation,the patient's tissue defect was repaired with different repair methods.Patients are divided into two groups according to different methods of tissue defect repair.That is,the use of the larynx trachea composite tissue flap repair group and the application of other methods to repair the group,Observe the differences in perioperative factors(including gender,age,comorbidities,primary tumor location,TNM staging,intraoperative conditions,postoperative drainage,and postoperative complications,etc.)between the two groups.Statistical analysis of the above factors was performed using different methods and was considered statistically significant when p<0.05.Result:The gender,basic diseases,primary tumor sites,and staging of the enrolled patients had no significant effect on the postoperative complications.However,the average age of the patients with the larynx tracheal flap repair group was higher,the operation time was less,the hemorrhage was less,the total hospital stay was short,and the cost was low,and this difference was statistically significant.The constitution ratio of the occurrence of infections,pharyngeal fistula,dysphagia,and other short-term complications after the repair of residual laryngeal tracheal flap was significantly lower than that of other composite flap repair groups,but this difference was not statistically significant.Conclusion : The use of residual laryngeal tracheal flap repair can not reduce the incidence of postoperative complications in patients.The application of the residual laryngeal-trachea composite tissue flap in the repair of hypopharyngeal carcinoma postoperative defect repair is feasible.It has the advantages of convenient material acquisition,short operation time,less trauma,short hospital stay,and low cost,but the method must sacrifice the laryngeal function.Preconditions should prevent abuse.The choice of treatment plan for each patient should be based on individual factors such as tumor factors,the patient's physical condition combined with the side effects of treatment,the incidence of complications,and the patient's tolerance.