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本文报告了我科近三年来收治的下咽及颈段食管癌12例,10例进行了手术,8例切除了肿瘤,其中7例采用了非开胸食管剥脱及胃移植,包括3例全喉及咽切除,另一例咽、喉切除及颈段食管切除后采用游离空肠自体移植重建食管。所有病例手术均较平稳。有三例发生严重并发症,一例术后死于心力衰竭,咽瘘及移植颈胃坏死各一例。胃部份坏死病例用腔内插管代替缺损,能进食软食后出院。随访6例中,2例于一年后死亡,4例生存。 下咽及颈段食管癌并不少见,手术切除率及其疗效不低于其他各段的食管癌。文中对手术适应证、力法及并发症进行了讨论。
This article reports 12 cases of hypopharyngeal and cervical esophageal cancer treated in our department in the past three years. 10 cases have undergone surgery, and 8 cases have had tumors removed. Among them, 7 cases used non-thoracotomy esophagectomy and gastric transplantation, including 3 cases Laryngeal and pharyngeal resection, another case of pharynx, laryngectomy, and cervical esophagectomy were performed using free jejunal autograft to reconstruct the esophagus. All cases were more stable. Three patients had severe complications. One patient died of heart failure after surgery, one case of pharyngeal fistula, and one case of cervical necrosis. In the case of gastric necrosis, intraluminal cannula was used as a substitute for the defect, and after eating soft food, it was discharged. Of the 6 patients followed up, 2 died after one year and 4 survived. Hypopharyngeal and cervical esophageal cancer is not uncommon, and the surgical resection rate and its efficacy are not lower than those of other segments of esophageal cancer. This article discusses the surgical indications, force methods and complications.