【摘要】 目的 觀察全喉全下咽切除術(shù)后空腸游離移植術(shù)二次手術(shù)時(shí)同時(shí)保留動(dòng)靜脈血管蒂或僅保留動(dòng)脈血管蒂時(shí)對(duì)移植組織的影響?！ 》椒ā』仡櫡治?002年1月-2009年12月4例下咽癌行全喉全下咽切除術(shù)空腸游離移植術(shù)術(shù)后8~18個(gè)月因頸部轉(zhuǎn)移灶出現(xiàn)而需再行手術(shù)患者的臨床資料，其中3例行根治性頸清掃，1例行局部包塊擴(kuò)大切除術(shù)。2例同時(shí)保留動(dòng)靜脈蒂，2例僅保留動(dòng)脈蒂?！〗Y(jié)果 4例術(shù)后臨床Ⅰ期愈合。保留動(dòng)靜脈蒂者吞咽功能與術(shù)前無(wú)異。僅保留動(dòng)脈蒂者術(shù)后1個(gè)月仍有頸中份的明顯隱痛，胃腸造影移植空腸段的蠕動(dòng)明顯減弱，吞咽固體食物時(shí)自覺(jué)較術(shù)前緩慢?！〗Y(jié)論 再次手術(shù)時(shí)保留血管蒂對(duì)于保持空腸移植段的活力具有重要的意義?！続bstract】 Objective To observe the effect of keeping arteriovenous or venous pedicles during the second free jejunal transplantation after total laryngopharyngectomy on the transplanted tissues. Methods From January 2002 to December 2009,four patients underwent total laryngopharyngectomy and free jejunal. But 8-18 months later, the patients underwent another operation because of recurrent metastatic mass in the ipsilateral neck side of anastomosis; in whom three underwent radical neck dissection and one underwent local enlarged mass resection. In the four patients, two had arteriovenous pedicles remained and another two kept only venous pedicles. Results All of the four patients experienced first-stage healing. The deglutitive function in the two patients who had received the arteriovenous pedicles preservation didn’t differ much from that before the operation. While vague anguish in the anterior region of the neck, weak peristalsis of the transplanted jejunum, a little discomfort and slow swallowing were found in another two patients. Conclusion Keeping vascular pedicles during re-operation helps make the activity of the transplanted jejunum.