Search

Acellular dermal matrix (ADM) can be used as a new membrane substitute for repairing mucosal defects. The objective of this study is to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in hypopharynx reconstruction. A total of 40 patients were treated with this surgical method to reconstruct hypopharynx in our department between February 2011 and October 2012. Patients were diagnosed had hypopharyngeal cancer located at lateral and/or postpharyngeal wall. The mucosal defect size after hypopharyngeal resection was 3 × 4 cm-6 × 7 cm, and was repaired by xeno-ADM. Patients were followed up for 11-36 months. 4 patients got infected, and two developed into pharyngeal fistula. Patients regained eating function 2-5 weeks after surgery. No membrane was removed; no severe stenosis of hypopharynx was observed. All patients were successfully decannulated. The overall 3-year survival rate is 67.5 %; the 3-year disease-free rate is 47.5 %. Reconstruction of hypopharynx by xeno-ADM is proved to be a simple, safe and effective method with fewer complications. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore xenogeneic acellular dermal matrix (ADM) in combination with pectoralis major myocutaneous flap in hypopharynx and cervical esophagus reconstruction. A total of five patients were treated with this surgical method to reconstruct hypopharynx and cervical esophagus in Second Xiangya Hospital between January 2012 and April 2013. Four of them had hypopharyngeal carcinoma with laryngeal and cervical esophageal invasion, while the fifth patient with hypopharyngeal cancer had developed scars and atresia after postoperative radiotherapy. The defect length after hypopharyngeal and cervical esophageal resection was 6-8 cm, and was repaired by a combination of ADM and pectoralis major myocutaneous flap by our team. Interestingly, the four patients had primary healing and regained their eating function about 2-3 weeks after surgery, the fifth individual suffered from pharyngeal fistula, but recovered after dressing change about 2 months. Postoperative esophageal barium meals revealed that the pharynx and esophagus were unobstructed in all five patients. Xenogeneic ADM in combination with pectoralis major myocutaneous flap for hypopharynx and cervical esophagus reconstruction is a simple, safe and effective method with fewer complications. Nevertheless, according to the defect length of the cervical esophagus, the patients need to strictly follow the medical advice. [ABSTRACT FROM AUTHOR]

The aim of our study is to present our experience in the diagnosis and treatment of patients with carotid artery rupture (CAR) due to foreign body ingestion. A total of nine admissions with CAR due to foreign body ingestion were recorded in Second Xiangya Hospital between 1969 and 2011. The carotid artery was sutured with muscle flap coverage in six cases, ligated in three cases. We retrospectively compared different surgical procedures of the patients and their clinical outcomes. Results show that CAR was found in all of these nine cases in imaging examinations or surgery. Among these six patients treated by suture of the carotid artery, five patients had a complete recovery without any complications, one patient underwent common carotid artery (CCA) ligation after suture surgery, but finally died of massive hemorrhage due to uncontrollable infection with carotid artery erosion. Among these three patients treated only by CCA ligation, one patient had no complications, one patient had hemiplegia, and one patient died of severe cerebral edema. Hence, timely diagnosis and open surgery are important for the patients of CAR due to foreign body ingestion. Suture of the carotid artery with muscle flap coverage is a better method compared with ligation of the carotid artery in the treatment of CAR. [ABSTRACT FROM AUTHOR]