摘要
目的 尝试采用游离空肠修复技术保留下咽颈段食管交界癌患者的喉功能.方法 2007年8月至2012年12月回顾性分析肿瘤同时位于下咽和颈段食管的13例鳞状细胞癌患者,均进行喉功能保留的外科治疗.原发灶T3期8例,T4期4例,放疗后复发rT2期1例.采用游离空肠部分剖开的方法同时修复下咽和颈段食管.10例患者接受了术后放疗（7例）或放化疗（3例）,放疗剂量49～65 Gy,平均56 Gy.结果 Kaplan-Meier方法计算13例患者的3年总生存率为47.9％,无瘤生存率为34.2％.9例（9/13）患者发生手术并发症,包括手术死亡1例和游离空肠坏死1例.5例（5/13）患者长期带气管套管.10例（10/13）患者完全恢复经口进食,全部患者恢复发音.结论 初步经验发现,部分有选择的下咽颈段食管交界癌患者可以运用游离空肠修复技术,保留喉功能,有利于提高患者生活质量.
Objective Try to use free jejunum flaps reconstruction and laryngeal preservation for squamous cell carcinoma （SCC） in the pharyngoesophageal junction. Methods Thirteen patients who underwent resections of SCC in the pharyngoesophageal junction with free jejunal interposition from August 2007 to December 2012 were reviewed. Of them, 8 had T3 lesions, 4 had T4 lesions, and one had radiation failure with rT2 lesion. Ten patients were treated with postoperative radiotherapy with a average dosage of 56 Gy. Results The 3 year over all survival rate was 47. 9% and disease-specific survival rate was 34. 2%. The surgical complications occurred in 9 patients （9/13）, including one death and one flap failure. Five patients （5/13） had permanent tracheal canulation, 10 patients （10/13） resumed oral feeding and all patients achieved reasonable speech. Conclusion Free jejunum interposition can be used to reconstruct surgical defect of SCC in the pharyngoesophageal junction, thus preserving the larynx and ensuring a better quality of life for the patients.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2014年第7期543-547,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
下咽肿瘤
食管肿瘤
修复外科手术
Hypopharyngeal neoplasms
Esophageal neoplasms
Reconstructive surgical procedures
