下咽癌及近端食管癌外科治疗价值的探讨  

Surgical management of cancer of the hypopharynx and proximal esophagus

作　　者：傅剑华[1] 黄植藩[1] 戎铁华[1] 张诠[1] 郭朱明[1] 

机构地区：[1]中山大学肿瘤防治中心胸科,广州510060

出　　处：《中华胃肠外科杂志》2004年第3期202-204,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨下咽癌及近端食管癌外科治疗的价值。方法回顾性分析1987年以来14例下咽癌及近端食管癌的外科治疗结果,其中下咽癌6例,近端食管癌8例。结果全组均行下咽、全喉、全食管切除,咽胃吻合术,其中3例并行双侧功能性颈清扫术。患者出院后全部随访。术后1例双肺感染,1例医院内死亡,1例吻合口狭窄;患者均能经口进食,日常生活自理;2例应用电子喉可进行交流。13例已死亡,中位生存期20个月。结论下咽、全喉、全食管切除,胃咽吻合术治疗下咽癌及近端食管癌方法可行,但预后差,生活质量欠满意,应探索更加有效的治疗方法。Objective To evaluate the clinical value of laryngo pharyngo esophagectomy(PLE) and pharyngogastric anastomoses(PGA) for cancer of the hypopharynx and proximal esophagus. Methods Fourteen patients undergoing PLE since 1987 were reviewed, including 6 cases with hypopharynx cancer and 8 with proximal esophagus cancer. Results Fourteen patients underwent PLE with PGA during the study period. Three of them underwent functional neck dissection synchronously. Follow up was complete for all the patients. Postoperative complications included in hospital death in one, double pneumonia in one and anastomosis stricture in one case. Functional outcomes including daily activities and swallowing function were acceptable. The mean survival time was from 2 to 28 months with a median survival time of 20 months. Conclusions Although PLE with PGA for hypopharynx and proximal esophagus cancer is an acceptable procedure, the prognosis is poor and the quality of life is not satisfactory. Interdisciplinary multi modality therapy should be carried out.

关 键 词：下咽癌 近端食管癌 外科治疗 咽胃吻合术 双侧功能性颈清扫术 全食管切除术 

分 类 号：R735.1[医药卫生—肿瘤] R739.63[医药卫生—临床医学]