山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 35-37.doi: 10.6040/j.issn.1673-3770.0.2015.049

• 论著 • 上一篇    下一篇

保留喉功能的梨状窝癌手术14例

钱小飞1, 张速勤2, 陈建良1   

  1. 1. 宜兴市人民医院耳鼻咽喉科, 江苏 宜兴 214200;
    2. 第二军医大学附属长海医院耳鼻喉科, 上海 200433
  • 收稿日期:2015-01-23 修回日期:2015-04-10 出版日期:2015-08-16 发布日期:2015-08-16
  • 作者简介:钱小飞。E-mail:qxf_2003@163.com

Laryngeal function-sparing surgery for pyriform sinus cancer: a retrospective analysis of 14 cases.

QIAN Xiaofei1, ZHANG Suqin2, CHEN Jianliang1   

  1. 1. Department of Otolaryngology, Yixing People's Hospital, Yixing 214200, Jiangsu, China;
    2. Department of Otolaryngology, Changhai Hospital of Second Military Medical University, Shanghai 200433, China
  • Received:2015-01-23 Revised:2015-04-10 Online:2015-08-16 Published:2015-08-16

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摘要： 目的 探讨保留喉功能的梨状窝癌手术方法和适应证。方法 梨状窝癌患者14例, Ⅰ期3例, Ⅱ期5例, Ⅲ期4例, Ⅳ期2例。行保留喉功能的手术治疗, 术后放疗40～55 Gy。结果 随访5年, 14例均恢复发音功能, 12例拔管。3年生存率为64.29%, 5年生存率为42.86%。结论 经严格术前评估, 大部分梨状窝癌患者可通过精细手术保留喉正常组织, 并通过多种修复方法恢复喉的全部或部分功能。

关键词: 下咽肿瘤, 咽切除术, 喉功能保留

Abstract: Objective To explore the approaches and indications of laryngeal function-sparing surgery for pyriform sinus cancer. Methods A total of 14 cases of pyriform sinus cancer were retrospectively reviewed, including stage Ⅰ (n=3), Ⅱ (n=5), Ⅲ (n=4) and Ⅳ (n=2). All patients received laryngeal function-sparing surgery, and then 40 to 55 Gy postoperative radiotherapy. Results During the follow-up of 5 years, all cases regained phonate function, and 12 cases' tracheal casings were removed. The 3-year and 5-year survival rate were 64.29% and 42.86%, respectively. Conclusion With careful preoperative evaluation, most patients with piriform sinus cancer can have normal laryngeal tissues preserved by delicate operation, and their larynx functions can be partially or completely restored with a variety of repair methods.

Key words: Hypopharyngeal neoplasms, Pharyngectomy, Preservation of laryngeal function

中图分类号: 

  • R739.63
[1] 房居高, 魏秀春, 蔡淑平, 等. 梨状窝癌局部扩展的病理学研究[J]. 中华耳鼻咽喉科杂志, 2000, 35(5):387-390.
FANG Jugao, WEI Xiuchun, CAI Shuping, et al. Histological study of the local-regional invasion of pyriform sinus carcinoma[J]. Chin J Otorhinolarynol Head Neck Surg, 2000, 35(5):387-390.
[2] 李学忠, 张立强, 潘新良, 等. 保留喉功能的梨状窝癌的手术治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2005, 40(3):212-216.
LI Xuezhong, ZHANG Liqiang, PAN Xinliang, et al. Preservation of laryngeal function in surgical treatment of pyriform sinus carcinoma[J]. Chin J Otorhinolarynol Head Neck Surg, 2005, 40(3):212-216.
[3] 邱连升, 吕佳宝, 王佳蓉, 等. 梨状窝癌的保留喉功能外科治疗[J]. 华中科技大学学报:医学版, 2009, 38(1):76-78.
QIU Liansheng, LV Jiabao, WANG Jiarong, et al. Preservation of laryngeal function in surgical operation for pyriform sinus cancer[J]. Acta Med Univ Sci Tech Huazhong, 2009, 38(1):76-78.
[4] 曾镇罡, 肖水芳, 赵恩民, 等. 喉功能保留的下咽癌外科治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(7):539-542.
ZENG Zhengang, XIAO Shuifang, ZHAO Enmin, et al. Surgical treatment for advanced carcinoma of hypopharynx and laryngeal function preservation[J]. Chin J Otorhinolarynol Head Neck Surg, 2014, 49(7):539-542.
[5] 张彬, 邬振华, 余济春, 等. T3和T4期梨状窝癌喉功能保留及游离皮瓣修复术[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(11):913-923. ZHANG Bin, WU Zhenhua, YU Jichun, et al. Hemi-pharyngolaryngectomy and laryngeal reconstruction with free flaps in T3 and T4 hypopharyngeal cancer[J]. Chin J Otorhinolarynol Head Neck Surg, 2013, 48(11):913-923.
[6] Frank J L, Garb J L, Kay S, et al. Postoperative radiotherapy improves survival in squamous cell carcinoma of the hypopharynx[J]. Am J Surg,1994, 168:476-480.
[7] Elias N M, Hilgers F J, Keus R B, et al. Carcinoma of the pyriform sinus: a retrospective analysis of treatment results over a 20-year period[J]. Clin Otolaryngol,1995, 20:249-253.
[8] Paximadis P, Yoo G, Lin H S, et al. Concurrent chemoradiotherapy improves survival in patients with hypopharyngeal cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 82(4):1515-1521.
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