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“端侧技术”:在梨状窝尖端 SCC 患者中,更多的器官保存和更少的发病率。

"End to Side Technique": More organ preservation with less morbidity in patients with pyriform sinus apex SCC.

机构信息

ENT and Head & Neck Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran; ENT and Head & Neck Research Center and Department, Five Senses Health Research institute, Hazrat Rasoul Akram Hospital, Tehran, Iran.

ENT and Head & Neck Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran; ENT and Head & Neck Research Center and Department, Five Senses Health Research institute, Hazrat Rasoul Akram Hospital, Tehran, Iran.

出版信息

Am J Otolaryngol. 2020 Jul-Aug;41(4):102505. doi: 10.1016/j.amjoto.2020.102505. Epub 2020 Apr 22.

Abstract

INTRODUCTION

Hypopharyngeal squamous cell carcinoma (SCC) is rare, but highly aggressive. Due to the advanced stage of this cancer at the time of diagnosis, radical surgery with reconstruction of pharynx is the standard care with high morbidity and mortality rate. A safer partial pharyngectomy could also be used for invasive hypopharyngeal cancer. In this study, we investigated the short and long-term outcomes in patients with SCC of the pyriform sinus apex undergoing standard partial pharyngectomy using a new suturing technique, called end to side technique.

METHODS

This case series was performed on 8 patients with SCC of the pyriform sinus apex at the otorhinolaryngology clinic. All participants underwent standard partial pharyngectomy using "end to side technique". Post-operative evaluations included 6 and 12 months CT scan and 1-year barium swallow.

RESULTS

Of 8 patients, 7 were male (87.5%) and 1 was female (12.5%) with a mean age of 60 years old. All patients were diagnosed at stage III of hypopharyngeal cancer and cervical lymph node involvement was reported in 3 patients (37.5%). Tumor margins were negative in all patients. Fistula was reported in 2 patients (25%) which was managed using conservative treatments.

CONCLUSIONS

According to our study, the standard partial pharyngectomy with end to side technique is a safe and feasible method for the surgical resection of the squamous cell carcinoma of the pyriform sinus apex with good short-term and long-term outcomes.

摘要

简介

下咽鳞状细胞癌(SCC)较为罕见,但侵袭性很强。由于这种癌症在诊断时已处于晚期,因此标准治疗方法是进行根治性手术并重建咽,该方法虽能提高生存率,但并发症发生率和死亡率较高。对于侵袭性下咽癌,也可以采用更安全的部分咽切除术。本研究采用一种新的缝合技术——端对侧技术,调查接受标准部分咽切除术的梨状窦尖 SCC 患者的短期和长期结局。

方法

本病例系列研究在耳鼻喉科诊所共纳入了 8 例梨状窦尖 SCC 患者,所有患者均采用“端对侧技术”行标准部分咽切除术。术后评估包括术后 6 个月和 12 个月的 CT 扫描和 1 年的钡餐检查。

结果

8 例患者中,男性 7 例(87.5%),女性 1 例(12.5%),平均年龄 60 岁。所有患者均被诊断为下咽癌 III 期,3 例(37.5%)患者存在颈部淋巴结受累。所有患者的肿瘤切缘均为阴性。2 例(25%)患者发生吻合口瘘,采用保守治疗。

结论

根据我们的研究,端对侧技术的标准部分咽切除术是一种安全可行的方法,可用于切除梨状窦尖的鳞状细胞癌,具有良好的短期和长期效果。

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