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目的 :探讨晚期喉咽癌侵犯颈段食管患者的围手术期处理方法。方法 :侵犯颈段食管的 7例喉咽癌患者中 ,6例行一侧功能性颈廓清 ,喉下咽全切除 ,颈段食管剥脱 ,胃上徙 ,胃咽吻合术 ;1例行一侧根治性颈廓清 ,喉下咽全切除 ,颈段食管剥脱 ,胃大部切除 ,结肠上徙 ,结肠残胃、结肠咽吻合术。术中 5例切除一侧甲状腺。结果 :术后并发胃咽吻合口瘘 1例 ,急性肾功能衰竭 1例 ,所有患者均有不同程度的呕吐及其他消化功能不适 ,经治疗顺利度过围手术期。结论 :加强晚期喉咽癌侵犯颈段食管患者的围手术期处理 ,可使患者顺利接受术后放疗等综合治疗 ,提高肿瘤的治愈率和患者的生存率。
Objective: To investigate the perioperative management of patients with advanced hypopharyngeal carcinoma invading the cervical esophagus. Methods: Of the 7 patients with hysteropharyngeal carcinoma who were involved in the cervical esophagus, 6 patients underwent functional neck dissection on one side, pharyngectomy on the larynx, esophageal exfoliation on the neck, gastric anastomosis and anastomosis of the stomach; Radical neck clearance, laryngectomy pharyngeal resection, cervical esophageal exfoliation, subtotal gastrectomy, colorectal migration, colon residual stomach, colon anastomosis. 5 cases of intraoperative resection of the thyroid. Results: One case had anastomotic fistula and one case had acute renal failure. All patients had varying degrees of vomiting and other digestive disorders. After successful operation, the patients underwent perioperative period. Conclusions: Perioperative management of patients with advanced laryngeal and pharyngeal carcinoma invading the cervical esophagus can enhance the cure rate and the survival rate of the patients.