Reconstructive surgery used for the treatment of advanced larynx carcinoma

摘要

Larynx carcinomas discovered in an advanced stage, determined a difficult management. In many of the cases it is necessary to perform a reconstruction of the pharynx after pharyngolaryngeal excision. Reconstruction can be achieved through several technics using different types of flaps. Between 1991-2001, there were hospitalized and solved 218 pacients with larynx carcinoma. 148 pacients were discovered in advanced stages (stage III - 82, stage IVA - 21, stage IVB - 30, stage IVC - 15). In 29 of them (stage III - 25, stage IVA - 4) we applied total laryngectomies and different excisions of the pharynx more than a half, followed by reconstruction using miocutaneous flap (23), fasciocutaneous flap (3) and gastric pull-up (3). Neck dissection was performed in all cases, followed by radiotherapy. The authors present the results. There was a higher rate of complications: pharyngocutaneous fistula - 8 (27%), partial necrosis flap - 3 (10,3%), wound infection - 4 (13,7%) and local recurrences - 15 (51,6%). The survival was the same with other statistics.