胃代食管术治疗下咽癌的可行性及其临床价值

背景与目的：由于下咽癌解剖部位的特殊性,传统仅作姑息性治疗.我们探讨下咽癌合并喉侵犯患者胃代食管术治疗下咽癌的可行性及其临床意义.方法：采用胃代食管术,并辅助放射治疗和适量化疗治疗42例下咽癌患者.手术范围：喉、咽切除,食管拔脱,下咽成形以及胃、口咽吻合术.放疗包括术前放疗和术后放疗.结果：无院内死亡,手术并发症3例,其中2例吻合口瘘,1例血胸,均治愈出院.3年生存率37.9%.结论：下咽癌手术切除率高,胃代食管术有明显的优势,采用下咽、喉切除胃代食管术加辅助放疗可有效的提高长期生存率,影响远期疗效的主要原因是局部复发.

Feasibility of surgical treatment of hypopharyngeal carcinoma with gastric transposition and its clinical value

Background and purpose:Most of the patients with hypopharyngeal cancer were treated with palliative surgery because of its unique anatomical position and advanced stage. We studied the feasibility and clinical value of surgical treatment using the stomach to replace the esophagus for hypopharyngeal carcinoma and its clinical value.Methods:Forty-two patients with hypopharyngeal carcinoma underwent surgical resection with gastric transposition, followed by radiotherapy (before and after operation) and adjuvant chemotherapy. The operation included laryngectomy, hypopharyngectomy, inversion-stripping esophagectomy, hypopharynx formation, gastric-oropharyngeal anastomosis.Results:Two patients had the complication of anastomotic fistula and one had hemothorax, they recovered after appropriate treatment. There was no in hospital mortality. 3-year survival rate was 37.9%.Conclusions:Gastric transposition for hypopharyngeal carcinoma was well explored and caused no severe surgery-related side effects. The method has shown some advantages over classic procedure and might improve both the local control and survival.