健侧半喉重建晚期梨状窝癌术后的咽部及颈段食管缺损

Hypopharynx and cervical esophagus reconstruction with remaining larynx and pharynx after operation on the advanced pyriform sinus cancer

目的 :探讨健侧半喉重建晚期梨状窝癌术后咽部缺损的治疗方法及治疗效果。方法 :对 12例晚期梨状窝癌患者行半喉半咽切除术 ,2例同时行颈段食管切除术 ,并用健侧半喉重建咽部及颈段食管缺损。结果 :术中无死亡病例。仅 1例术前放疗的病人术后发生咽漏 ,全部病例愈合后均可进普通饮食 ,也无吞咽梗阻。目前 ,所有病例随访时间均超过 2年 ,其 2年生存率为 75 % ,最长存活 5年。结论 :利用半喉半咽切除术后残存的正常喉粘膜瓣重建晚期梨状窝癌术后咽部及颈段食管缺损 ,取材方便 ,操作简单 ,创伤小 ,并发症少。

Objective:To evaluate the outcome of hypopharynx reconstruction using remaining larynx and pharynx in patients after hemipharyngectomy,partial laryngectomy and cervical esophagectomy.Methods:Twelve patients with advanced pyriform sinus cancer underwent hemipharyngectomy and partial laryngectomy.Two patients underwent cervical esophagectomy at the same time.All cases were reconstructed by the remaining larynx.Results:All cases were successful.Only one patient suffered from postoperative pharyngocutaneous fistulas,who had had perioperative radiotherapy.Patients could swallow ordinary foods and had no strictures after operation.Up to now,patients have been followed over 2 years,and two-year survival rate was 75%.One case has survived over 5 years. Conclusion:The hypopharynx reconstruction with remaining larynx and pharynx is simple and convenient.It is less invasive and has less complication.