하인두암종에서 전후두인두절제술 후 유리피판 재건술의 비교 연구
Comparative Study of Free Flap Reconstruction after Total Laryngopharyngectomy for Hypopharyngeal Cancer
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Background and Objectives Recently, both jejunal and fasciocutaneous free flap reconstruction are widely used after total laryngopharyngetomy for the treatment of hypopharyngeal cancer. The aim of this study is to evaluate and compare the functional outcomes between jejunal and fasciocutaneous free flap in the reconstruction of hypopharynx after total laryngopharyngectomy. Subjects and Method The medical records of 27 patients with hypopharyngeal cancer who underwent total laryngopharyngectomy and free flap reconstruction were reviewed retrospectively. Of 27 patients, 18 (66.7%) were reconstructed with jejunal free flap and 9 (33.3%) with fasciocutaneous free flap. We compared complications, flap success rates, functional outcomes such as swallowing, respiration and quality of life (QOL) between two reconstruction groups. The swallowing function was evaluated by Functional Outcome of Swallowing Scale (FOSS), and QOL was evaluated by EORTC QOL-C30, HN35. Results Twenty-seven patients consisted of 26 males and 1 female. The mean age of 69±9.1. There were 4, 13, and 10 cases for T2, T3, and T4, respectively. Also, there were 8, 5, 7, and 7 for N0, N1, N2 and N3 cases. The success rate of free flap was 96.3%. The complication rate, operative time, the period of hospital stay did not differ between the two groups. The average score of FOSS was 0.92 in the jejunal group and 1.00 in the fasciocutaneous group. Quality of life was satisfactory in both groups. Conclusion Both jejunal and fasciocutaneous free flap are very effective reconstructive methods after total laryngopharyngectomy for hypopharyngeal cancer. The choice of free flap can be determined based on the individual status of patient and preference of surgeon.
Abstract
Background and Objectives Recently, both jejunal and fasciocutaneous free flap reconstruction are widely used after total laryngopharyngetomy for the treatment of hypopharyngeal cancer. The aim of this study is to evaluate and compare the functional outcomes between jejunal and fasciocutaneous free flap in the reconstruction of hypopharynx after total laryngopharyngectomy. Subjects and Method The medical records of 27 patients with hypopharyngeal cancer who underwent total laryngopharyngectomy and free flap reconstruction were reviewed retrospectively. Of 27 patients, 18 (66.7%) were reconstructed with jejunal free flap and 9 (33.3%) with fasciocutaneous free flap. We compared complications, flap success rates, functional outcomes such as swallowing, respiration and quality of life (QOL) between two reconstruction groups. The swallowing function was evaluated by Functional Outcome of Swallowing Scale (FOSS), and QOL was evaluated by EORTC QOL-C30, HN35. Results Twenty-seven patients consisted of 26 males and 1 female. The mean age of 69±9.1. There were 4, 13, and 10 cases for T2, T3, and T4, respectively. Also, there were 8, 5, 7, and 7 for N0, N1, N2 and N3 cases. The success rate of free flap was 96.3%. The complication rate, operative time, the period of hospital stay did not differ between the two groups. The average score of FOSS was 0.92 in the jejunal group and 1.00 in the fasciocutaneous group. Quality of life was satisfactory in both groups. Conclusion Both jejunal and fasciocutaneous free flap are very effective reconstructive methods after total laryngopharyngectomy for hypopharyngeal cancer. The choice of free flap can be determined based on the individual status of patient and preference of surgeon.
참고문헌 (20)
- Persky MS, "Combined therapy vs curative radiation in the treatment of pyriform sinus carcinoma", Otolaryngol Head Neck Surg, 89(1), pp.87~91 (1981)
- Pingree TF, "Treatment of hypopharyngeal carcinoma: a 10-year review of 1,362 cases", Laryngoscope, 97(8 Pt 1), pp.901~904 (1987)
- Spaulding MB, "Preoperative chemotherapy for hypopharyngeal carcinoma", Laryngoscope, 93(3), pp.346~349 (1983)
- Anthony JP, "Phar yngoesophageal reconstruction using the tubed free radial forearm flap", Clin Plast Surg, 21(1), pp.137~147 (1994)
- Salassa JR, "A functional outcome swallowing scale for staging oropharyngeal dysphagia", Dig Dis, 17(4), pp.230~234 (1999)
- Aaronson NK, "The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology", J Natl Cancer Inst, 85(5), pp.365~376 (1993)
- Kim YH, "Reconstruction with radial forearm free flap in hypopharyngeal cancer", Korean J Otolaryngol, 38(6), pp.939~946 (1995)
- Ryu BH, "Clinical application of the radial forearm free flap", Korean J Plastic Reconstr Surg, 15, pp.489~501 (1988)
- Yoo JY, "Pharyngoesophageal reconstruction with forearm free flap", Korean J Otolaryngol, 33(6), pp.1193~1197 (1990)
- Song R, "The forearm flap", Clin Plast Surg, 9(1), pp.21~26 (1982)
- Koshima I, "Free anterolateral thigh flaps for reconstruction of head and neck defects", Plast Reconstr Surg, 92(3), pp.421~430 (1993)
- Kim YH, "Perforator Flaps in Head and Neck Reconstruction", Hanyang Med Rev, 29(3), pp.265~273 (2009)
- Murray DJ, "Fasciocutaneous free flaps in pharyngolaryngo-oesophageal reconstruction: a critical review of the literature", J Plast Reconstr Aesthet Surg, 61(10), pp.1148~1156 (2008)
- Lewin JS, "Functional outcomes after circumferential pharyngoesophageal reconstruction", Laryngoscope, 115(7), pp.1266~1271 (2005)
- Yu P, "Comparison of clinical and functional outcomes and hospital costs following pharyngoesophageal reconstruction with the anterolateral thigh free flap versus the jejunal flap", Plast Reconstr Surg, 117(3), pp.968~974 (2006)
- Perez-Smith D, "Jejunal free flap reconstruction of the pharyngolaryngectomy defect: 368 consecutive cases", J Plast Reconstr Aesthet Surg, 66(1), pp.9~15 (2013)
- Joo YH, "Fasciocutaneous free flap reconstruction for squamous cell carcinoma of the hypopharynx", Eur Arch Otorhinolaryngol, 268(2), pp.289~294 (2011)
- Joseph DL, "Risks of head and neck surgery in previously irradiated patients", Arch Otolaryngol, 97(5), pp.381~384 (1973)
- Disa JJ, "Microvascular reconstruction of the hypopharynx: defect classification, treatment algorithm, and functional outcome based on 165 consecutive cases", Plast Reconstr Surg, 111(2), pp.652~663 (2003)
- Moradi P, "Reconstruction of pharyngolaryngectomy defects using the jejunal free flap: a 10-year experience from a single reconstructive center", Plast Reconstr Surg, 126(6), pp.1960~1966 (2010)