保留喉功能的下咽癌切除术

Laryngeal Function Preservation in Surgical Treatment of Hypopharyngeal Carcinoma

本文报道了保留喉功能的下咽癌切除术７２例，其中梨状窝癌４８例，环后癌５例，下咽上区癌６例及下咽后壁区癌１３例，绝大多数病变为Ⅲ期（３３）和Ⅳ期（２２）．均为鳞癌。术后喉功能完全恢复４５例，部分恢复２６例，功能丧失１例。５年存活率分别是梨状窝癌为４３％，下咽上区癌５０％，环后癌６０％，而下咽后壁癌无１例存活５年。局部复发４例均位于咽部，无１例发生于保留的残喉。本文描述了手术适应证，手术类型和重建方法。作者等认为保留喉的正常部分，重建喉功能，并不影响肿瘤的彻底切除。

cases of hypopharyngeal carcinomas which had been treated by conservative hy-popharyngectomy wcre evaluated,including 48 pyriform sinus,5 postcricoid,6 superior hy-popharyngeal and 13 posterolateral pharyngeal wall carcinomas,with most patients in Stage Ⅲ(33)and Ⅳ(22).There were 64 men and 8 women. All had sqamous cell carcinomas and were between the ages of 35 and 68,Postoperatively,the laryngeal functions were restored completely in 45 cases and partially in 26 with 1 failure. The 5-year survival rate was 43%(pyrifoim sinus),50 %(superior hypopharynx),60 %(postcricoid) respectively and none of the pesterolateral hy-popharyngeal wall patienls,survived over 5 years.There were 4 recurrences in the pharynx and none from the preservcd laryngeal remnants Indications,types of surgical procedures and reconstructive techniquerq are outlined.It is sug-gerRted that preeservation of the normal part of the larynx is feasible for both the eradication of the tumor and Dreservation of the laryngeal funcitions.