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目的 探讨下咽癌的外科治疗效果。方法 回顾性分析 1970— 1998年间 96例 (男性 85例 ,女性11例 ,年龄 35～ 74岁 )经手术治疗的下咽癌 ,病理均为鳞状细胞癌。单纯手术 31例 ,综合治疗 6 5例。4 2例 (44 % )作了喉功能保留手术 ,5 4例 (5 6 % )未保留喉功能。同期单颈清扫 5 5例 ,双颈清扫 2 7例。结果 96例总 5 a生存率为 35 %。单纯手术 5 a生存率为 2 3% ,综合治疗为 4 2 %。喉功能保留组为 38% ,未保留组为 33% ,两组差异无显著性。淋巴结转移率为 81% ,并发症发生率为 35 % ,以咽瘘最常见。结论 下咽癌治疗以综合治疗较单纯手术效果好。不影响生存率的前提下 ,保留喉功能的下咽癌手术较未保留喉功能者 ,有效地提高了生存质量。对于下咽癌 c N1～ 3者 ,应该行根治性颈清扫 ;对于 c N0 者 ,倾向行颈侧清扫术。
Objective To investigate the surgical treatment of hypopharyngeal carcinoma. Methods A retrospective analysis of 96 cases (85 males, 11 females, aged 35-74 years) with surgical treatment of hypopharyngeal carcinoma from 1970 to 1998 was performed. The pathology was all squamous cell carcinoma. 31 cases of simple surgery, comprehensive treatment of 65 cases. Forty-two (44%) patients underwent laryngeal function preservation and 54 (56%) did not retain laryngeal function. Fifty-five patients had single neck dissection during the same period and 27 patients had double neck dissection. Results 96 cases of total 5 a survival rate was 35%. The 5-year survival rate of simple surgery was 23% and the comprehensive treatment was 42%. Laryngeal function reserve group was 38%, unreserved group was 33%, no significant difference between the two groups. Lymph node metastasis rate was 81%, complication rate was 35%, the most common pharyngeal fistula. Conclusions The treatment of hypopharyngeal carcinoma is more effective than simple surgery in the treatment of hypopharyngeal carcinoma. Without affecting the survival rate under the premise of preserving laryngeal function of hypopharyngeal cancer surgery than those who did not retain laryngeal function, effectively improve the quality of life. For hypopharyngeal cancer c N1 ~ 3, radical neck dissection should be performed; for cN0 who tend to line neck dissection.