Sasaki C T, Salzer S J, Cahow E, Son Y, Ward B
Department of Surgery, Yale University School of Medicine, New Haven, Conn. 06510, USA.
Laryngoscope. 1995 Feb;105(2):160-3. doi: 10.1288/00005537-199502000-00009.
The 5-year survival rate for patients with hypopharyngeal squamous cell carcinoma invading the upper esophagus is below 25% regardless of therapy. Most patients with advanced disease--unable to eat or breathe--die within 18 months of diagnosis. Because these patients, on average, have a limited time to live, surgical treatment should aim to maximize the quality of remaining life. Essential to this goal are complete tumor removal and rapid return to oral feeding. Furthermore, short hospital stay and low perioperative morbidity are especially important in these patients. We performed total laryngopharyngoesophagectomy (LPE) with gastric transposition in 34 patients with hypopharyngeal and cervical esophageal squamous cell carcinoma. There has been one perioperative death (3%) and 1 temporary fistula (3%). No major mediastinal or intrathoracic complication occurred. On average, patients began oral feeding by postoperative day 10, with return to a full diet and discharge home within 16 days, maximizing both quality and quantity of time remaining outside the hospital.
下咽鳞状细胞癌侵犯上段食管患者的5年生存率低于25%，无论采用何种治疗方法。大多数晚期患者（无法进食或呼吸）在确诊后18个月内死亡。由于这些患者平均存活时间有限，手术治疗应旨在最大限度地提高剩余生命的质量。实现这一目标的关键是彻底切除肿瘤并迅速恢复经口进食。此外，缩短住院时间和降低围手术期发病率对这些患者尤为重要。我们对34例下咽和颈段食管鳞状细胞癌患者实施了全喉下咽食管切除术（LPE）并进行胃移位术。围手术期死亡1例（3%），出现1例暂时性瘘（3%）。未发生重大纵隔或胸内并发症。患者平均在术后第10天开始经口进食，16天内恢复正常饮食并出院，最大限度地提高了院外剩余时间的质量和数量。
