Conservative surgery method of hypopharyngeal carcinoma / 上海第二医科大学学报

ABSTRACT

Objective To evaluate the feasibility of different kinds of surgeries to treat hypopharyngeal carcinoma and investigate the methods to conduct one-stage repair after hypopharyngeal carcinoma removal. Methods Thirty nine cases of hypopharyngeal carcinoma were treated from May 2000 to Mar 2007, of which 27 were originated from pyriform sinus, 8 from postcricoid and 4 from posterior pharyngeal wall. One-stage reconstruction for hypopharyngeal and esophageal defect was done with simple and less-damaged hypopharyngeal plasty by local sewing, infrahyoid muscle flap, pectoralis major flap and supplement of esophagus by stomach. Results The defect of 18 cases was repaired by sternohyoid muscle flap, including 13 from pyriform sinus, 4 from root of tongue and 1 from posterior pharyngeal wall. Seven were repaired by substitute of esophagus by stomach, 5 by local sewing, 4 by cervical flap and 2 by pectoralis major myocutaneous flap. All the patients were successfully followed up during the survival days. Half of the cases suffered from slight deglutitory disorder after operation and recovered soon, while 2 cases were still with worse deglutitory function. All the cases were recovered with laryngeal function, and 21 cases were decannulated with normal respiration and voice, and 18 with cannula. Thirteen cases survived for more than 3 years after operation and 5 cases more than 5 years, while 14 cases died within 1 year. Thirteen cases were carried out another operations for local recurrence or metastases of lymph nodes, one of whom experienced 6 operations. The estimated 3-year survival was 43.3% (13/30), and 5-year survival was 37.5%(3/8). Conclusion Hypopharyngeal carcinoma with different site and stage can be treated by different methods, and one-stage reconstruction can be done to repair the defect of pharynx and esophagus with satisfactory functional restoration and prognosis.