METHOD FOR CLOSING THE PHARYNGEAL DEFECT IN PATIENTS AFTER LARYNGECTOMY Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine; otorhinolaryngology; oncology.

SUBSTANCE: in the lower part of the pharyngeal defect, a needle is injected and threaded into the serous-muscular layer of the esophagus in a horizontal direction. Next, an injection is made into the serous-muscular layer without injecting the mucous membrane from the pharynx and the needle and thread are threaded through the thickness of this layer for 2-3 cm. Then the same needle is used to inject and thread the serous-muscular layer of the tongue root in the medial area in the horizontal direction. After that, the edges of the defect are pulled together with a thread and a fixing knot is performed, dividing the pharyngeal defect into two equal parts. Then, in one of the obtained parts, a needle is injected into the serous-muscular layer of the esophagus in the lower part of the defect, with the mucosa being captured on the needle and sutured to the mucosal-muscular layer of the tongue root, tightening the captured edges. The next suture is done similarly, continuing the suturing, moving from the medial part of the defect to its lateral edge. After suturing the lateral defect with a serous-muscular suture, a second row of continuous entwining suture is formed with the capture of the constrictors of the pharynx and the muscles of the tongue root in the opposite direction with respect to the first suture. Next, the thread is fixed to the central knot. Similarly, suturing is performed on the other side. Then, in the lower part of the defect, the membranous part of the trachea is mobilized and separated from the esophagus for 1.5-2 cm. From the sternum, the medial bundles of the sternocleidomastoid muscles are cut off on both sides. It is moved to the formed bed between the membranous part of the trachea and the anterior wall of the esophagus and fixed with a U-shaped suture to the esophagus and the membranous part of the trachea. Active aspiration drainage is installed through the counterincision in the supraclavicular area. Layer-by-layer subcutaneous-fat tissue and skin are sutured.

EFFECT: method allows creating favorable conditions for the primary wound healing after laryngectomy and reducing the risk of postoperative complications.

1 cl, 6 dwg, 2 ex