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目的探讨非开胸胃代食管术治疗同时性下咽并胸段食管重复癌的方法和疗效。方法对5例同时性下咽并胸段食管重复癌患者,均行非开胸食管内翻拔脱胃上徙术。喉功能保留3例,其中1例下咽后壁癌患者因胃上徙高度不够,采用前臂桡侧游离皮瓣修复下咽及颈段食管;全喉切除2例。结果5例吞咽功能全部恢复,无吞咽困难发生。1例发生咽瘘,经保守治疗痊愈。3例保留喉者均有不同程度呛咳症状。3例保留喉功能者术后全部拔管,发音质量良好。随访1~4年,1年生存率100%(5/5),3年生存率60%(3/5)。结论提高对同时性下咽并胸段食管重复癌的认识,采用非开胸胃代食管术治疗,优越性为成功率高、并发症较少,是一个较理想的手术方法。
Objective To investigate the method and efficacy of non-open thoracic esophagectomy for simultaneous esophageal hypopharyngeal carcinoma and esophageal cancer. Methods Five patients with simultaneous esophageal hypopharyngeal carcinoma and thoracic esophageal carcinoma underwent esophagectomy and non-thoracotomy. Thoracic function retained in 3 cases, of which 1 case of hypopharyngeal wall cancer patients due to inadequate elevation of the stomach, the use of forearm free radial flap to repair the hypopharynx and cervical esophagus; total laryngectomy in 2 cases. Results 5 cases of swallowing all recovered without dysphagia. 1 case of pharyngeal fistula, cured by conservative treatment. 3 cases of retention laryngeal have varying degrees of cough symptoms. Three cases of laryngeal function were preserved after extubation, pronunciation of good quality. Follow-up 1-4 years, 1-year survival rate was 100% (5/5), 3-year survival rate of 60% (3/5). Conclusion To improve the understanding of concurrent hypopharyngeal and esophageal recurrent esophageal cancer, non-open thoracic esophageal esophageal treatment is superior to the high success rate and less complications, which is an ideal surgical method.