Đánh giá kết quả sớm điều trị phẫu thuật ung thư hạ họng giai đoạn III, IV có tạo hình bằng vạt da cơ ngực lớn=Evaluation of early results of surgical treatment for stage III and IV hypopharyngeal cancer with reconstruction using pectoralis major myocutaneous flaps

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Tác giả: Văn Nhạ Hoàng, Đức Thuận Nghiêm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.45-53

Bộ sưu tập: Metadata

ID: 244732

Thêm vào giỏ

Điều trị ung thư hạ họng giai đoạn III, IV cần đa mô thức trong đó phẫu thuật là phương pháp quan trọng để kiểm soát bệnh tại chỗ và vùng cổ. Nghiên cứu của chúng tôi gồm 51 bệnh nhân ung thư hạ họng giai đoạn III, IV được phẫu thuật và có tạo hình bằng vạt da cơ ngực lớn tại Bệnh viện K từ tháng 11/2020 đến tháng 3/2022. Kết quả cho thấy ung thư vị trí xoang lê là hay gặp nhất chiếm 76,5%. Cắt thanh quản toàn phần - hạ họng bán phần là loại p hẫu thuật thực hiện nhiều nhất chiếm 58,8%. 100% vạt ngực lớn sống trong đó có 5,9% bệnh nhân vạt hoại tử 1 phần. Biến chứng hay gặp nhất sau mổ là rò ống họng chiếm 15,7% và giảm dần xuống 5,9% sau 1 tháng và 3,9% sau 3 tháng. Các yếu tố làm tăng nguy cơ rò ống họng là Albumin máu <
34 g/L (p = 0,005), xạ tiền phẫu (p = 0,17), mở khí quản cấp cứu (p = 0,237), BMI <
18,5 kg/m2 (p = 0,046) và Hemoglobin máu <
130 g/l (p = 0,052).Treatment for stage III and IV hypopharyngeal cancer requires multimodal therapy. Surgery is an important method for controlling the disease locally and in the neck region. Our study includes 51 patients with stage III and IV hypopharyngeal cancer who underwent surgery and reconstruction using pectoralis major myocutaneous flaps at K Hospital from November 2020 to March 2022. The results showed that the most common site of cancer was the piriform sinus, accounting for 76.5%. Total laryngopharyngectomy was the most performed type of surgery, accounting for 58.8%. All pectoralis major flaps survived, with 5.9% of patients experiencing partial flap necrosis. The most common postoperative complication was pharyngocutaneous fistula, occurring in 15.7% of patients, which decreased to 5.9% after one month and 3.9% after three months. Factors increasing the risk of pharyngocutaneous fistula included blood albumin levels <
34 g/L (p = 0.005), preoperative radiation (p = 0.17), emergency tracheostomy (p = 0.237), BMI <
18.5 kg/m2 (p = 0.046), and blood hemoglobin levels <
130 g/L (p = 0.052).

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