Surgical Operation and Perioperative Management for Elderly Hypopharyngeal Cancer Patients
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摘要: 目的 探讨70岁以上高龄下咽癌患者安全有效的治疗方法。方法 回顾性分析安徽医科大学第一附属医院耳鼻咽喉头颈外科共85例70岁以上高龄下咽癌患者住院治疗的临床资料。手术治疗组68例，非手术治疗组17例。Kaplan-Meier法计算生存率，用卡方检验比较两组并发症发生率和拔管率。结果 手术组和非手术组患者5年生存率分别为38.2%（26/68）和5.9%（1/17），差异有统计学意义（P=0.005）。手术组中70~75岁年龄组和>75岁年龄组的5年生存率分别为38.6%（17/44）和37.5%（9/24），差异无统计学意义（P=0.26）。68例手术患者中45例行喉功能保留术，术后均恢复呼吸、吞咽和发音功能；23例未保留喉功能，术后均恢复呼吸和吞咽功能。手术患者并发症发生率为41.2%（28/68），70~75岁和>75岁年龄组的并发症发生率分别为38.6%（17/44）和45.8%（11/24），差异无统计学意义（P=0.56）。70~75岁和>75岁年龄组的拔管率分别为61.4%（27/44）和62.5%（15/24），差异无统计学意义（P=0.93）。结论 高龄下咽癌患者根据其全身状况及肿瘤的侵犯范围选择适当的手术方式是可行、安全有效的。Abstract: Objective To explore the secure and effective surgical methods for elderly(>70 years old) hypopharyngeal carcinoma patients. Methods A retrospective analysis of the clinical materials of 85 elderly hypopharyngeal carcinoma patients was conducted from Otolaryngology Head and Neck Surgery Department of the First Affiliated Hospital of Anhui Medical University. Sixty-eight cases were in surgery group and the other 17 cases were in non-surgery group. Kaplan-Meier method was used to calculate the survival rate and chi-square test was used to compare the complication rate and decannulation rate between two groups. Results The 5-year survival rate of patients in the surgery group was 38.2%(26/68) and in the non-surgery group was 5.9%(1/17), with significant difference (P=0.005). In the surgery group, the 5-year survival rate of patients from 70 to 75 years old was 38.6%(17/44), while patients over 75 years old was 37.5% (9/24), without significant difference(P=0.26).In the surgery group, 45 cases had laryngeal function preservation and restored breathing, swallowing and pronouncing functions after surgery, while the other 23 cases did not preserve laryngeal function and all restored breathing and swallowing function after surgery. In the surgery group, the complication rate after surgery was 41.2% (28/68), and complication rate of patients from 70 to 75 years old was 38.6%(17/44), while patients over 75 years old was 45.8%(11/24), without significant difference(P=0.56); and the decannulation rate of the two age groups were 61.4%(27/44) and 62.5%(15/24), respectively, without significant difference(P=0.93). Conclusion It is secure and effective for elder hypopharyngeal cancer patients to choose proper surgeries according to their general conditions and the extent of tumor invasion.
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Key words:
- Pharynx tumor /
- Pharyngectomy /
- Laryngectomy /
- Elder people
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