下咽及胸部食管癌的外科治疗

Kai Li, Yue-jun Chen, G. Xiao, Qiu-yi Zou, Yi Tang, Wen-Chieh Huang, Zan Li
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摘要

目的探讨下咽、胸部食管癌检查的临床价值。方法回顾性分析2013年1月至2019年7月收治的20例下咽及胸部食管癌的手术治疗资料。结果同时发生下咽、食管癌11例。异慢性下咽、胸部食管癌9例。20例均为鳞状细胞癌。同步手术包括全咽咽食管切除术、胃管插入咽胃吻合术、颈部及纵隔淋巴结清扫术、气管切开术。异慢性手术包括一期根治性下咽切除术,二期根治性食管切除术。术后并发症包括院内死亡1例,双侧肺炎3例,吻合口狭窄1例。咽胃瘘2例。吞咽功能均恢复。结论喉咽食管切除术咽胃吻合术治疗下咽、胸部食管癌虽简单可行,但生存质量不理想。虽然结肠食管置换手术比较复杂,但患者的生活质量是最好的。关键词:食道肿瘤;Hypopharyngeal-neoplasms;手术
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Surgical treatment of the hypopharynx and chest esophageal carcinoma
Objective To evaluate the clinical value of the the hypopharynx and chest esophageal carcinoma. Methods 20 patients surgical treatment data of the hypopharynx and chest esophageal carcinoma from January 2013 to July 2019 were reviewed. Results The simultaneous hypopharynx and esophageal carcinoma 11 cases. The heterochronic hypopharynx and chest esophageal carcinoma 9 cases. 20 cases are all squamous cell carcinoma. The synchronus operation included total pharyngolaryngo esophagectomy, gastric tube interposition pharyngo gastric anastomic, neck and mediastinal lymph nodes dissection, tracheostomy. The heterochronic operation included the first stage radical hypopharygealectomy, the second stage radical esophagealectomy. Postoperative complications included in hospital death in one, double pneumonia in 3 and anastomosis stricture in one case. Pharynx gastric fistula in 2. Swallowing function were all recovered. Conclusion Although laryngo pharyngo esophagectomy and pharyngogastric anastomoses for the hypopharynx and chest esophageal carcinoma is a simple and acceptable procedure, the quality of life is not satisfactory. And although colon interpasation for esophageal replacement is complicated the quality of life is the best. Key words: Esophageal-neoplasms; Hypopharyngeal-neoplasms; Surgery
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