Dağli Safak, Unsal E Evrim, Arikan Osman, Ozdem Cafer
2nd Department of Ear Nose and Throat Diseases, Ankara Numune Hospital, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2002 Sep-Oct;9(5):363-7.
Gastric pull-up is a common technique in the reconstruction of gastrointestinal continuity following surgery for the primary esophageal and hypopharyngeal tumors with involvement of the esophagus. We evaluated the results of surgery in patients with cervical esophageal and hypopharyngeal cancers.
Eleven patients (4 women, 7 men; mean age 46 years; range 18 to 70 years) underwent surgery for hypopharyngeal and cervical esophageal epidermoid carcinoma. Surgery included pharyngolaryngoesophagectomy, subtotal thyroidectomy, and gastric pull-up in all patients. In addition, nine patients had radical neck dissection on the involved side and modified radical neck dissection on the contralateral side. One patient had bilateral radical neck dissection. Patients who were alive were followed-up for a mean period of 27 months (range 14 to 46 months).
The one-, two-, and three-year survival rates were 54% (6/11), 36% (4/11) and 18% (2/11), respectively. Three patients died from early postoperative complications, two from organ failure due to locoregional recurrence (7th month) and to distant metastasis (11th month).
Despite the small size of the study, the results favor the use of gastric pull-up in selected patients with cervical esophageal and hypopharyngeal cancers.
胃上提术是原发性食管和下咽肿瘤累及食管手术后重建胃肠道连续性的常用技术。我们评估了颈段食管癌和下咽癌患者的手术结果。
11例患者(4例女性,7例男性;平均年龄46岁;年龄范围18至70岁)接受了下咽和颈段食管表皮样癌手术。所有患者的手术均包括下咽食管切除术、甲状腺次全切除术和胃上提术。此外,9例患者在患侧进行了根治性颈清扫术,在对侧进行了改良根治性颈清扫术。1例患者进行了双侧根治性颈清扫术。存活患者的平均随访时间为27个月(范围14至46个月)。
1年、2年和3年生存率分别为54%(6/11)、36%(4/11)和18%(2/11)。3例患者死于术后早期并发症,2例死于局部区域复发(第7个月)和远处转移(第11个月)导致的器官衰竭。
尽管本研究样本量较小,但结果支持在选定的颈段食管癌和下咽癌患者中使用胃上提术。