喉咽癌累及食管颈段的手术处理

目的总结喉咽癌累及食管颈段手术处理的经验。方法回顾分析44例喉咽癌累及食管颈段患者的病例资料,沿安全缘完整切除肿瘤,行改良颈淋巴结清扫术,修复咽和食管缺损,重建喉功能。结果 54.5%的患者淋巴结包膜受侵犯,40.9%的患者保留了喉功能,20.5%的患者出现并发症。全组患者的5年生存率为36.4%,其中淋巴结包膜未侵犯和喉功能保留患者的生存率显著增高(P<0.05)。结论喉咽癌累及食管颈段时,只要切除完整,修复得当,可以明显提髙患者的生存率和术后生存质量。

Surgical treatment of hypopharyngeal cancer with cervical esophageal invasion

Objective To summarize the experience of the surgical treatment of hypopharyngeal cancer with cervical esophageal invasion.Methods A total of 44 patients with advanced hypopharyngeal cancer with cervical esophageal invasion from 1995 to 2008 were examined in this study.The clinical data were collected and analysed retrospectively.The tumors were resected completely along the safety margin,and patients received modified neck dissection.After that,the defects of the pharynx and esophagus were repaired,and the functions of throat were reconstructed.Results The lymph node extracapsular spread was found in 54.5% of patients.The laryngeal function was retained in 40.9% of patients.The postoperative complications were found in 20.5% of patients.The overall 5 year survival rates were 36.4%.The patients who had no lymph node extracapsular spread and whose laryngeal function was persevered had a significantly higher survival rate(P<0.05).Conclusion In the patients with hypopharyngeal cancer with cervical esophageal invasion,the complete excision and proper repair can significantly improve the survival rate and postoperative quality of life.