放射治疗 (RT) 失败后进行游离瓣重建的挽救性口咽手术面临着独特的挑战和并发症。本回顾性综述的目的是检查放疗后因复发性或持续性口咽癌接受挽救性手术的患者的手术并发症和功能结果。2016 年至 2021 年间在佛罗里达大学诊断为口咽癌并接受挽救性口咽切除术的患者来自头颈肿瘤团队的住院和门诊记录。测量的结果是气管造口依赖、管饲依赖和完整的口服摄入状态。使用 Kaplan-Meier 乘积限法计算生存结果。分析中包括 26 名患者。平均年龄为 63.7 岁。 14 例 (53.8%) 口咽切除术采用经下颌入路，10 例 (38.5%) 采用经口和经颈联合入路，2 例 (7.7%) 采用经颈入路。气管切开拔管的平均时间为 25.1 天。 6 个月时，20 名患者 (83.3%) 不再依赖胃管，其中 12 名患者 (54.2%) 可以耐受任何口服摄入。 12 个月时，不依赖胃管进食的患者减少至 9 名 (60%)，其中 13 名 (92.9%) 患者可以耐受经口摄入。中位总生存期为 27 个月，局部癌症复发是最常见的死亡原因。因复发性疾病而接受挽救性口咽切除术的患者继续面临长时间的气管切开术和管依赖喂养。尽管吞咽功能完好，但患者更喜欢使用胃管喂养，可能是因为速度、轻松和方便。需要进一步的研究来分析影响这些相互冲突的功能结果的因素以及影响生存的预测因素。版权所有 © 2024 Elsevier Ltd. 保留所有权利。

Salvage oropharyngeal surgery with free-flap reconstruction after failed radiation therapy (RT) presents unique challenges and complications. The aim of this retrospective review is to examine surgical complications and functional outcomes in patients who received salvage surgery for recurrent or persistent oropharyngeal cancer following RT.Patients diagnosed with oropharyngeal cancer and underwent salvage oropharyngectomy at the University of Florida between 2016-2021 were identified from inpatient and outpatient records of the Head and Neck Oncology Team. Outcomes measured were tracheostomy dependence, tube-feed dependence, and intact oral intake status. Survival outcomes using Kaplan-Meier product limit method were calculated.Twenty-six patients were included in the analysis. Average age was 63.7 years. Fourteen (53.8 %) oropharyngectomies used a transmandibular approach, ten (38.5 %) through a combined transoral and transcervical approach, and two (7.7 %) through a transcervical approach. Average time to tracheostomy decannulation was 25.1 days. At 6 months, twenty (83.3 %) patients were gastric tube independent with twelve (54.2 %) patients tolerating any oral intake. At 12 months, gastric tube independent feeds decreased to nine (60 %) patients with thirteen (92.9 %) patients tolerating oral intake. The median overall survival was 27 months with local cancer recurrence being the most common cause of death. Patients undergoing salvage oropharyngectomy for recurrent disease continue to face prolonged tracheostomy and tube dependent feedings. Despite intact swallowing function, patients preferred to use gastric tube feedings, likely for speed, ease, and convenience. Further studies are needed to analyze factors influencing these conflicting functional outcomes and predictive factors impacting survival.Copyright © 2024 Elsevier Ltd. All rights reserved.