| Objective: Because the structure and function of the head and neck are complicated,reconstruction after tumor resection has always been a pressing issue.Some patients with hypopharyngeal cancer have not been involved in the laryngeal structure in the current clinical diagnosis and treatment,but they must undergo total laryngectomy due to the large defect after resection,thus losing their laryngeal function;Some patients with hypopharyngeal cancer lost the opportunity of operation due to the large defect after resection.Because of its unique characteristics and blood supply,the island flap of the supraclavicular artery has obvious advantages for throat defects.In this paper,7 patients with hypopharyngeal cancer who underwent supraclavicular artery island flap repair were chosen for postoperative analysis and follow-up,and other patients in the same period and stage were chosen for comparison,in order to study the benefits and drawbacks of the island flap of supraclavicular artery in repairing the defect of hypopharyngeal cancer,as well as patient survival time and quality of life.Methods: Patients with hypopharyngeal cancer who underwent selective supraclavicular artery island flap repair at Shengjing Hospital,affiliated with China Medical University,were recruited between November 2020 and November 2022.The patients were divided into stages based on preoperative electronic laryngoscope,CT,and intraoperative conditions,and 7 patients with hypopharyngeal cancer in the same stage were chosen to observe their postoperative recovery and follow-up.The above seven groups’ relevant clinical data and follow-up results were examined.The postoperative hospital stay,daily drainage,and time of pulling out the nasal feeding tube and tracheal cannula were all recorded,and a long-term follow-up was performed to assess laryngeal function recovery and survival time.Results: The percentage of patients who underwent supraclavicular artery island flap repair in stages T1,T2,and T3 was 100%,whereas the traditional procedure in the same stage could not preserve laryngeal function.In the T4 stage,the percentage of patients who underwent supraclavicular artery island flap repair was 100%,whereas the traditional operation in the same stage lost the opportunity for complete resection.2.The experimental group’s average operation time was 172.43 minutes longer than the control group’s(P<0.001,95%CI[-228.8,-116.1]).3.The drainage days were 1.86 days longer in the experimental group than in the control group(P=0.88,95%CI[-4.086,0.3720]),and shoulder and neck drainage had no effect on the data.4.Between the two groups,there was a statistical difference in daily drainage of the affected hypopharyngeal area(P=0.0058,95%CI[-5.639,-1.330]).While there was no significant difference in daily drainage of the affected neck lymph node dissection area and the healthy side.5.The experimental group’s average postoperative hospital stay was 7.85 days longer than the control group’s(P=0.0013,95%CI[-11.25,-4.462]).6.The experimental group’s average time to remove the nasal feeding tube was 4.86 days longer than the control group’s(P=0.0013,95%CI[1.77,7.947]).7.In the experimental group,5 patients underwent partial hypopharyngeal resection combined with supraclavicular artery island flap repair,and the tracheal cannula was removed on the average 23.3±2.28 days after operation(P<0.001,95%CI[20.37,26.03]),and the patients underwent total laryngectomy for life after operation.8.I was able to swallow solid food for half a month after the operation,and I was able to swallow paste and liquid food again at one month.When combined with the time it took to remove the nasal feeding tube,the average ability to swallow was15.71 days after surgery.9.The patient has no phonation function after total laryngectomy with supraclavicular artery island flap repair,whereas the patient has phonation function after partial hypopharyngeal resection with supraclavicular artery island flap repair,and the patient clearly recovered one month after the operation.10.Shoulder skin recovery: By January 2023,all patients who underwent skin flap repair reported that their shoulder skin felt tight.11.Survival time: One patient in the experimental group died of lung cancer in January 2023.The control group produced no results.Conclusion: Although supraclavicular artery island flap repair takes slightly longer than traditional surgery,it can successfully preserve laryngeal function in T2 and T3 stages.At the T4 stage,the lesion site can be completely removed while maintaining the safety margin.Longer observation is required to determine the effect on survival time. |
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