A Clinical Study Of Preventing Pharyngeal Fistule After Hypopharyngeal Carcinoma By Lifting The Thyroid Lobe For Reinfrocing Phyrynx

ObjectiveTo observe the probability of pharyngeal fistula after pyriform sinus carcinoma resection by different surgical procedures, and reseach the effort of preventing pharyngeal fistula after pyriform sinus carcinoma resection which lift the thyroid lobe for reinforcing phyrynx.Materials and MethodsA total of92cases with intact data of pyriform sinus carcinoma resection were retrospectively analyzed form Sep2011to Jan2013and Jan2005to Jan2006in the Qilu Hospital of Shandong University,88cases of males and4cases of females,age39-77years old. In the cases,all the patients were directly sutured and Retaining laryngeal function.65cases was performed unilateral lymphnode dissection and27cases was performed bilateral lymphnode dissection. According to the stage of hypopharyngeal carcinoma:stage Ⅰ6Example, stage Ⅱ51Example,stage Ⅲ17Example, stage Ⅳ17Example;90cases’ pathology was squamous-cell carcinoma,2cases were carcinosarcom. Remove the cases of past neck surgery and diabetes mellitus.Based on different surgical methods, The patients were divided into two groups:group with reinforcing phyrynx by thyroid lobe(group A,72cases) and group did not use the thyroid lobe. In the group A, there was stage Ⅰ1Example, stage Ⅱ9Example,stage Ⅲ35Example, stage IV27Example, free the thyroid lobe and spare it, when chosed the pharyngeal cavity, lifting it and suturing it to the posterior belly of digastric muscle; in the group B, there was stage Ⅰ1Example, stage Ⅱ3 Example,stage Ⅲ9Example, stage IV7Example, because of the limit of surgical procedures, group did not use the thyroid lobe. We statistics the quantity of pharyngeal fistula, analysis and contract the two group by the SAS9.1, clear the effect of preventing pharyngeal fistula after hypopharyngeal carcinoma which lifti the thyroid lobe for reinforcing phyrynx.Resultsthere was no statistical significant between group A and group B under the constituent ratio of hypopharyngeal carcinoma stage.In group A(72cases),there were69cases successfully discharged and3cases were appear pharyngeal fistula, the morbidity rate was4.35%(3/72).In group B(20cases),there were16cases successfully discharged and4cases were appear pharyngeal fistula, the morbidity rate was20%(4/20).There was statistical significant between group A and group B(P=0.0378<0.05) after contracting the data.ConclusionsThere was statistical significant (P=0.0377<0.05) between the group A and group B on the morbidity rate of pharyngeal fistula. Lifting the thyroid lobe to reinforce the phyrynx can reduce the pharyngeal fistula obviously.So, to the patients whose thyroid lobe was not invaded by tumor, free and keep it before we entered the pharyngeal cavity, then lift and suture it to the posterior belly of digastric muscle and filled the dead space outside of the anastomosis, it had effect effect to prevent pharyngeal fistula after hypopharyngeal carcinoma.