{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282680200074752.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.5981/jjhnc.33.346"}},{"identifier":{"@type":"NAID","@value":"130004509976"}},{"identifier":{"@type":"NAID","@value":"10019775951"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2008083096"}}],"dc:title":[{"@language":"en","@value":"Salvage operation after concurrent chemo-radio therapy"},{"@language":"ja","@value":"化学放射線療法後のＳａｌｖａｇｅ手術―術後合併症―"}],"dcterms:alternative":[{"@language":"ja","@value":"―術後合併症―"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"Background: In an attempt to improve survival and keep organ function for cases with advanced head and neck carcinoma, recently concurrent chemoradiotherapy is widely used.<BR>Objective: To evaluate complications of salvage surgery following organ preservation therapy.<BR>Setting: University referral hospital.<BR>Method: Six-year retrospective outcome analysis of 22 patients with resectable head and neck squamous cell carcinoma of the hypopharynx (15), mesopharynx (5), larynx (1) and tongue (1).<BR>Results: The overall complication rate was 13/22 (59%). There were four major complications such as carotid rupture soon after wound infection. The operation time and total blood loss were clearly increased in salvage surgery compared to the control. Complications were greatly reduced by decreasing the area of neck dissection or using DP flap instead of injured cervical skin. Overall five-year survival rate of hypopharyngeal cancer with salvage operation was 50% in early cases and 30% in advanced cases.<BR>Conclusion: Using DP flap and reducing the operation area (super-selective neck dissection) was effective to decrease the complication rate of salvage operation."},{"@language":"ja","@value":"近年，化学放射線同時併用療法の普及と共に，再発例のsalvage 手術症例も増加している。今回，自験例を検討し，その問題点を明らかにした。対象は，2001年以降，根治切除可能症例で化学放射線同時併用療法後に再発を来たし，salvage手術を施行した22例である。原発巣は下咽頭15，中咽頭5，喉頭1，舌1例である。下咽頭癌13例に空腸再建が行われ，残り2例は頸部郭清のみであった。中咽頭癌は3例に再建が施行され2例は一期縫縮した。喉頭は全摘両頸部郭清，舌は部分切除，下顎辺縁切除が行われた。合併症は，2004年までの4例で術後晩期の感染から，頸動脈破裂を来たした。合併症率は59%に達した。組織障害による肉芽形成不全のため小死腔残存し，感染をきたすためと思われた。そのため2005年以降，DP皮弁で皮膚張り替えし，術後肉芽形成を期待し，更に頸部郭清範囲の縮小，dead spaceの管理等の工夫を加え，合併症は減少した。全例，病理学的には根治切除できたが，遠隔転移7例，局所再発4例，手術関連死2例を認め，無病生存は8例のみであった。化学放射線同時併用療法後のsalvage手術では，合併症予防のため，必要最小限の手術範囲とすべきであり，頸部皮切のデザインには，細心の注意を払い，血流不良の場合はDP皮弁の使用を躊躇せず，dead spaceの管理の留意する必要があると思われた。"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410853646355258240","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000258078473"},{"@type":"NRID","@value":"9000017340265"}],"foaf:name":[{"@language":"en","@value":"Sugasawa Masashi"},{"@language":"ja","@value":"菅澤 正"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Head and Neck Sugery, Comprehensive Cancer Center, International Medical Center, Saitama Medical University"},{"@language":"ja","@value":"埼玉医科大学国際医療センター包括的がんセンター頭頸部腫瘍科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13495747"},{"@type":"EISSN","@value":"18818382"},{"@type":"PISSN","@value":"http://id.crossref.org/issn/13495747"},{"@type":"NCID","@value":"AA11985555"}],"prism:publicationName":[{"@language":"en","@value":"Toukeibu Gan"},{"@language":"ja","@value":"頭頸部癌"},{"@language":"en","@value":"Toukeibu Gan"},{"@language":"ja","@value":"頭頸部癌"}],"dc:publisher":[{"@language":"en","@value":"Japan Society for Head and Neck Cancer"},{"@language":"ja","@value":"日本頭頸部癌学会"}],"prism:publicationDate":"2007","prism:volume":"33","prism:number":"3","prism:startingPage":"346","prism:endingPage":"351"},"reviewed":"false","url":[{"@id":"https://search.jamas.or.jp/link/ui/2008083096"}],"availableAt":"2007","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Hypopharynx","dc:title":"Hypopharynx"},{"@id":"https://cir.nii.ac.jp/all?q=Concurrent%20chemoradio%20therapy","dc:title":"Concurrent chemoradio therapy"},{"@id":"https://cir.nii.ac.jp/all?q=Salvage%20operation","dc:title":"Salvage operation"},{"@id":"https://cir.nii.ac.jp/all?q=DP%20flap","dc:title":"DP flap"},{"@id":"https://cir.nii.ac.jp/all?q=Superselective%20neck%20dissection","dc:title":"Superselective neck dissection"},{"@id":"https://cir.nii.ac.jp/all?q=%E4%B8%8B%E5%92%BD%E9%A0%AD%E7%99%8C","dc:title":"下咽頭癌"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%8C%96%E5%AD%A6%E6%94%BE%E5%B0%84%E7%B7%9A%E5%90%8C%E6%99%82%E4%BD%B5%E7%94%A8%E7%99%82%E6%B3%95","dc:title":"化学放射線同時併用療法"},{"@id":"https://cir.nii.ac.jp/all?q=Salvage%E6%89%8B%E8%A1%93","dc:title":"Salvage手術"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%90%88%E4%BD%B5%E7%97%87","dc:title":"合併症"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360011143940861312","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Postoperative complications after chemoradiation for advanced head and neck cancer"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574096406606720","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Geometrical Method for the Generalized Moore Equations of a One-Dimensional Cavity with Two Moving 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chemoradiotherapy"},{"@language":"ja","@value":"下咽頭癌における化学放射線療法後の救済手術合併症―咽喉頭食道摘出空腸置換術について―"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001205224104320","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy","isCitedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Post-operative radiation therapy for locally advanced hypopharyngeal carcinoma"},{"@language":"ja","@value":"局所進行下咽頭癌に対する術後放射線療法の遡及的検討"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001205280805376","@type":"Article","relationType":["isReferencedBy","isCitedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Our experience of microvascular free tissue transfer in head and neck cancer reconstruction"},{"@value":"当科における遊離移植による頭頸部再建手術の検討"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001205282234112","@type":"Article","relationType":["isCitedBy"],"jpcoar:relatedTitle":[{"@value":"頭頸部癌に対する超選択的動注化学放射線療法後の救済手術"},{"@language":"en","@value":"Salvage surgery after super-selective arterial infusion 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Chemoradiotherapy"},{"@language":"ja","@value":"化学放射線治療後の再発下咽頭癌に対する救済手術とその臨床病理学的検討—原発巣の浸潤様式について—"},{"@value":"化学放射線治療後の再発下咽頭癌に対する救済手術とその臨床病理学的検討 : 原発巣の浸潤様式について"},{"@language":"ja-Kana","@value":"カガク ホウシャセン チリョウ ゴ ノ サイハツ カ イントウガン ニ タイスル キュウサイ シュジュツ ト ソノ リンショウ ビョウリガクテキ ケントウ : ゲンパツ ソウ ノ シンジュン ヨウシキ ニ ツイテ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282679990423168","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Treatment of Multiple Primary Cancers of the Head, Neck and Esophagus with Concurrent S-1 and Nedaplatin/Radiation Therapy"},{"@language":"ja","@value":"頭頸部癌と食道癌の重複癌に対するS-1，Nedaplatin/放射線同時併用療法の検討"},{"@language":"ja-Kana","@value":"アタマ ケイブガン ト ショクドウガン ノ チョウフクガン ニ タイスル S-1,Nedaplatin/ホウシャセン ドウジ ヘイヨウ リョウホウ ノ ケントウ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282680198100480","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Role of salvage surgery after concurrent chemoradiotherapy 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