Tube Gastric Repair After Total Larynx,Total Hypopharynx And Esophagus Resection Clinical Efficacy Analysis

Objectve: To investigate and analyze local advanced hypopharyngeal carcinoma or cervical esophageal carcinoma involving hypopharynx,postoperative effect of total larynx,total hypopharynx and total esophagus resection for tubular gastric repai,analysis of factors affecting postoperative survival.Mtheods: A retrospective study was conducted to analyze the therapeutic effects and factors affecting the survival of the upper gastrointestinal tract reconstructed with tubular stomach repair after total throat,total hypopharynx and total esophagus resection due to the invasion of esophageal or cervical esophageal cancer by local advanced hypopharyngeal carcinoma from January 2008 to December 2016 at Shengjing Hospital affiliated to China Medical University.For 25 patients with complete treatment data,postoperative cause of death analysis,postoperative complications analysis,postoperative survival analysis.A single factor analysis showed that lymph node metastasis,postoperative complications,tumor metastasis or recurrence were the risk factors for postoperative survival(P<0.05).Results: All 25 patients had no severe complications such as chest and stomach syndrome,arrhythmia,anastomotic fistula and so on.There were 14 postoperative complications and pleural effusion was the main postoperative complication(8cases,57.14%).A total of 16 postoperative deaths were attributed to tumor metastasis(9,56.25%).Survival analysis showed that survival rate was 56%,40% and 36% in 1,3 and5 years after operation.Cox regression multivariate analysis showed that postoperative complications,metastasis or recurrence were independent risk factors affecting postoperative survival time.Conclusion: 1.Stage IV hypopharyngeal carcinoma involving the neck and esophagus,or cervical esophageal carcinoma involving the hypopharynx without breaking through the esophageal muscular layer is feasible for throat,total hypopharynx and esophagus resection of tubular stomach repai,there were no severe complications such as chest and stomach syndrome,arrhythmia,anastomotic fistula and so on.2.The main cause ofpostoperative death is postoperative tumor metastasis,the survival rates were 56%,40%and 36% in 1 year,3 years and 5 years after operation.3.Survival analysis showed that three risk factors,including preoperative lymph node metastasis,postoperative complications,postoperative tumor metastasis or recurrence,were independent risk factors for postoperative survival;postoperative complications,postoperative tumor metastasis or recurrence are independent risk factors affecting postoperative survival time.