摘要
报道113例下咽及颈段食管癌患者分别应用岛状胸大肌肌皮瓣、咽胃吻合术、结肠代食管、游离空肠或前臂游离皮瓣以及残存下咽粘膜等方法重建上消化道,全组早期吞咽功能恢复率为94.6%。应用保留全喉或部分喉以及T-E分路等方法同时重建发音功能者25例,占总数的22.1%。全组1、3、5年生存率分别为79.6%、60.2%、40.7%。手术死亡2例,占全组的1.8%。作者认为所应用的上消化道重建方法是有效而可靠的,某些病例同时恢复和重建发音功能的措施也是可行的,值得临床推广。
Abstract From April 1984 to December 1996 , 113 patients with hypopharyngeal and cervical esophageal cancers were treated by different recostructive methods ,and the effects for the rehabilitation of upper alimentary and voice func- tion were evaluated. There were 92 males and 21 females , ranging in age from 23 to 73 years. Seventy of 113 pa- tients were diagnosed pyriform sinus cancer , 25 cervical esophageal cancer , 12 post wall cancer of hypopharynx and 6 postcricoid cancer. Stage Ⅲand stage Ⅳ were 83%. The pectoralis major myocutaneous flap (PMF) was used in 53 patients , total gastric transposition (GT) in 29 ,hypopharygeal mucosa (HM) in 18,colon interposition (CI) in 5, free jejunal transfer (FJT) in 4 , free forarm flap (FFF) in 3 and cervical flap (CF) in 1.Of 25 patients under- went voice rehabilitation or reconstruction (VR) , including 12 preserved total larynx , 11 partial larynx and 2 T-E shunt. One hundred and seven of 113 patients (94.6%) showed satisfactory and lasting deglutitory function were achieved. Twenty five patients showed satisfactory speaking function. One, three and five-year survival rate were 79.6 %, 60. 2% and 40. 7% respectively. These data show that the reconstructive method described above are effec- tive and reliable. My data suggest that PMF ,CT ,HM and CI are practical procedures for replacement of upper ali- mentary tract and suiatable for most clinically encountered situations. The VR is suitable for some patients of hy- popharyngeal and cervical esophageal cancer selected.
出处
《中国耳鼻咽喉头颈外科》
1998年第S1期3-6,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery