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保留喉功能的下咽癌手术治疗

王天铎 李学忠 卢永田 于振坤

中华医学杂志(英文版)2002,Vol.115Issue(6):892-896,5.
中华医学杂志(英文版)2002,Vol.115Issue(6):892-896,5.

保留喉功能的下咽癌手术治疗

Preservation of laryngeal function in treatment of hypopharyngeal carcinoma

王天铎 1李学忠 1卢永田 1于振坤1

作者信息

  • 1. 山东大学齐鲁医院耳鼻咽喉科,济南,250012
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摘要

Abstract

Objective To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. Methods A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage Ⅰ, n=6; stage Ⅱ, n=12; stage Ⅲ, n=82; stage Ⅳ, n=205), the sites of origin were pyriform sinus (n=234), postcricoid (n=21), posterior pharyngeal wall (n=35) and superior hypopharynx (n=15). Of the 305 patients, 206 (67.54%, stage Ⅰ, n=6; stage Ⅱ, n=12; stage Ⅲ, n=65; stage Ⅳ, n=123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage Ⅲ, n=17; stage Ⅳ, n=82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need. Results A total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage Ⅰ), 71% (stage Ⅱ), 58% (stage Ⅲ), and 36% (stage Ⅳ). The 5-year survival of the laryngeal function preserved group was 48% (n=66), the rate of complications 28% (n=58) and the rate of residual tumor 5.8% (n=12), compared with the no laryngeal function preserved group 37% (n=20), 31.3% (n=31), and 6% (n=6) (P>0.05). Conclution Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.

关键词

下咽肿瘤/咽切除术/保留喉功能

Key words

hypopharyngeal neoplasm/hypopharyngectomy/preservation of laryngeal function

分类

医药卫生

引用本文复制引用

王天铎,李学忠,卢永田,于振坤..保留喉功能的下咽癌手术治疗[J].中华医学杂志(英文版),2002,115(6):892-896,5.

中华医学杂志(英文版)

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