| Objective: Through analyzing the operation situation of thoracoscopic total laryngo-pharyngo-esophagectomy(TTLPE),the short-term and long-term complications,postoperative recovery,long-term survival,we explored the feasibility of multi-disciplinary TTLPE,and summed up the experience of surgical treatment.Methods: The clinical data of 31 patients with hypopharyngeal carcinoma treated by total laryngopharyngeal esophagectomy from May 2009 to June2019 were retrospectively analyzed.The general data,intraoperative conditions,postoperative pathology,short-term and long-term complications,and follow-up survival rate were analyzed to explore the specific efficacy and prognosis of multidisciplinary cooperative thoracoscopic total laryngopharyngeal esophagectomy.The survival rate was calculated by Kaplan Meier method.SPSS 18.0 software was used for data analysis.Results: The average age of 31 cases was 62 years old,including 20 cases of hypopharyngeal carcinoma,9 cases of cervical esophageal carcinoma and 2 cases of double primary carcinoma.There were 9 cases of routine chemotherapy,15 cases of chemoradiotherapy and 7 cases of no treatment.No patient died during the perioperative period.The average operation time was 290 minutes.The average time of tracheotomy,chest,neck and abdomen were 11 minutes,63 minutes and 214 minutes respectively.The average blood loss was 200 ml,and the average postoperative discharge was 13 days.After operation,there were 4 cases of pulmonary infection,2 cases of anastomotic fistula,2 cases of heart failure,1 case of chylothorax and 1 case of incision infection.The long-term complications included 2 cases of anastomotic stenosis,4 cases of feeding reflux and 3 cases of obvious cough.All patients were followed up for 5 years.Four cases were lost to follow-up,which occurred in the second year and the fourth year respectively.The 3-year and 5-year survival rates were 52.6% and 27.6%,respectively.Conclusion: Thoracoscopic total laryngo-pharyngo-esophagectomy is a huge traumatic operation,which should be minimally invasive as far as possible.It can improve the operation efficiency,reduce the incidence of complications,and provide patients with better short-term quality of life and survival rate.According to our experience,thoracoscopic total laryngopharyngeal esophagectomy with multidisciplinary cooperation is safe and effective. |
