【摘要】 目的 探讨下咽癌内镜手术中提前凝闭喉上动脉的可行性及手术效果，为减少术中出血、优化手术进程提供参考。方法 选取2016-08-01-2023-08-31宁阳县第一人民医院收治的80例下咽癌患者，采用随机数字表法分为观察组(40例)和对照组(40例)。对照组采用常规内镜手术(未预处理喉上动脉),观察组在经口内镜手术中主动解剖并提前凝闭喉上动脉。χ~2检验或t检验比较2组手术时间、术中出血量、术后并发症发生率及复发情况。结果 观察组手术时间为(40.08±7.58) min,短于对照组的(48.53±14.12) min,t=3.335,P=0.001;观察组术中出血量为(24.03±8.27) mL,少于对照组的(42.85±15.38) mL,t=6.817,P<0.001。观察组术后并发症发生率为2.50%(1/40),低于对照组的15.00%(6/40),χ~2=3.914,P=0.048。观察组术后复发率为10.00%(4/40),无瘤生存率为90.00%(36/40);对照组术后复发率为12.50%(5/40),无瘤生存率为87.50%(35/40),2组复发率及无瘤生存率比较差异无统计学意义(P>0.05)。结论 下咽癌内镜手术中提前凝闭喉上动脉可有效缩短手术时间、减少术中出血量及术后并发症，且不增加复发风险。更多还原

【Abstract】 Objective To evaluate the feasibility and surgical outcomes of superior laryngeal artery pre-coagulation in endoscopic surgery for hypopharyngeal carcinoma, providing references for reducing intraoperative bleeding and optimizing surgical procedures. Methods Eighty hypopharyngeal carcinoma patients admitted to Ningyang County First People’s Hospital from August 1, 2016, to August 31, 2023, were randomly divided into the observation group(n=40) and the control group(n=40) by using a random number table. The control group underwent conventional endoscopic surgery(without superior laryngeal artery pretreatment), while the observation group received active dissection and pre-coagulation of the superior laryngeal artery during transoral endoscopic surgery. The χ~2 test or t-test were used to compare operative time, intraoperative blood loss, postoperative complication rates, and recurrence between the two groups.Results The operative time in the observation group was(40.08±7.58) min, significantly shorter than that in the control group(48.53±14.12) min, t=3.335, P=0.001. The intraoperative blood loss in the observation group was(24.03±8.27) ml, significantly less than that in the control group(42.85±15.38) ml, t=6.817, P<0.001. The postoperative complication rate was 2.50%(1/40) in the observation group, lower than 15.00%(6/40) in the control group, χ~2=3.914, P=0.048. The recurrence rate was 10.00%(4/40) in the observation group, with a disease-free survival rate of 90.00%(36/40), compared to 12.50%(5/40) and 87.50%(35/40) in the control group, respectively. No statistically significant difference was observed in recurrence or disease-free survival rates(P>0.05).Conclusion Pre-coagulation of the superior laryngeal artery in endoscopic surgery for hypopharyngeal carcinoma effectively reduces operative time, intraoperative blood loss, and postoperative complications without increasing recurrence risk.更多还原