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[Surgical management of stomal recurrence]
Xinliang Pan1, Liqiang Zhang, Fenglei Xu
1Department of Otolaryngology, Qilu Hospital of Shandong University, Jinan 250012.
Objective:
To study effective treatment of stomal recurrence.
Method:
Thirty-one patients with stomal recurrence underwent surgical management. Twelve of them considered to have the probability of metastasis to regional lymphnodes underwent modified radical neck dissection. Twenty-five cases(I and II type) received complete tumor excision, but for III and IV type, only 50% (3/6) of the patients gained complete tumor excision. The surgical defects were repaired by pectoralis major myocutaneous flap in all the patients.
Result:
In 13 cases of type I, 7 cases had followed up for 3 years, 4 cases died, while in 12 cases of type II, 8 cases had followed up for 3 years, 5 cases died. Survival remains poor for III or IV type. Most of them died within 3 years after operation. The complication rate of pharyngeal fistula and pneumatothorax was 12.9% and 9.7%, respectively.
Conclusion:
The overall prognosis of stomal recurrence is dismal. A proper surgical treatment in some cases will prolong the lifetime and improve their quality of life.