下咽癌外科治疗41例分析

本文回顾41例下咽癌病人的外科治疗效果，5年生存率为37.5％（12／32），其中咽胃吻合术病例5年生存率为35．7％（5／14）。无手术死亡病例。产生各种并发症者为41．4％（17／41）。全部病人均恢复吞咽功能，部分病人保留了喉功能。本文就下咽癌的综合治疗、咽胃吻合术及下咽癌手术中喉功能的保护等问题进行讨论。

Analysis of surgical management for hypopharyngeal carcinoma on 41 patients

Forty-one patients with hypopharyngeal carcinoma were treated surgery between1983 and 1995. There were 37 males and 4 females, ranging in age from 47 to 72 years.The TNM classiffication was T1N0 in 1, T2N0 in 4, T2N1 in 1, T3N0 in 10, T3N1 in 13,T3N2 in 6, T4N0 in 1, T4N1 in 3, T4N2 in 1, and T4N3 in 1. Twenty-three patients received preoperative radiotherapy, ten postoperative radiotherapy, and surgery alone in8. According to the extension of the lesion, different kinds of operation were applied ,including partial or total laryngectomy and pharyngectomy. Our results showed that the3-and 5-year survival rates were 47. 4% (18/38) and 37. 5% (12/32) respectively. The5-year survival rale was 35. 7% (5/14) in patients who underwent stomatopharyngealanastomosis. No patient died of surgery. Severe complications of these patients werefound in 41. 4 % (17/41 ). The swallow function recovered to normal in all patients. Thecombination of different management, the protection of swallow and speech function inpatients with hypopharyngeal carcinoma were discussed.