摘要
为了改善病人的生存质量，作者对４例晚期下咽癌（Ｔ３，Ｔ４）患者行近全喉下咽切除、食管内翻剥脱、咽胃吻合发音重建术。术后给予６０钴放射治疗。手术由气管切开、咽喉切除、胃的游离、食管剥脱并提胃到颈部、胃咽吻合，将术中保留的喉组织制成最大径１．０～１．２ｃｍ发音分路吻合于咽胃吻合的前部。术后随访２年以上，２年生存率７５％（３／４），发音功能好，无明显误吸。术式取材方便、手术简便、并发症少、成功率高。对于晚期下咽癌是一种可行的咽胃吻合发音重建方法。
AbstractTo improve patients, life quality,speech rehabilitation was performed in four patients with advanced hypopharyngeal carcinoma(T3,T4 ) by the methed of esophageal inversion and denudation and pharyngogastric anastomosis after subtotal laryngectomy and pharyngec-tomy;Among the 4 cases,two were male and two female, The patients, age ranged between 36 to 57 years old.They got irradiation of 60Co from 40 to 50 Gy within 4 or 5 weeks post-operation,Squamous cell carcinoma was confirmed in all 4 cases.The separation of the surgical fields permits a twoteam approach: head and neck surgical team for laryngopharyngectomy, with an abdominal surgical team concomitantly mobilizing the stomach. This operation consists of five parts:(1)the laryngopharyngectomy,(2)the mobilization of the stomach,(3)the mobilization of the esophagus and the“pull up” of esophagus and stomach into the neck,(4) the division of the esophagus from the stomach then anastomosing to the remaining pharynx,(5)the normal laryngeal tissue retained intra-operation was used for making up of the speaking shunt and its maximum diameter is 1. 0 to 1.2cm,and then it was anastomosed to anterior part of the pharyngogastric anastomosis is stoma.Two years survival rate was 7%(3/4 ) and postoperative vocal function was good enoughwithout obvious aspiration。 We believe it is a feasble methd for speech rehablitation after pharngogastric anastomosis。
出处
《耳鼻咽喉（头颈外科）》
1995年第3期150-152,共3页
Chinese Arch Otolaryngology-Head Neck Surg
