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[目的]探讨下咽及颈段食管癌外科治疗中上消化道和发音功能重建方法之有效性、可靠性以及尚存在的问题。[方法]1984年4月至1996年12月共为113例下咽及颈段食管瘤患者进行了手术治疗。其中有53例应用岛状胸大肌肌皮瓣、29例应用咽胃吻合术、18例应用残存咽粘膜、5例结肠代食管、4例游离空肠、3例前臂游离皮瓣和1例颈部皮瓣重建上消化道。利用保留全喉12例、保留部分喉11例和气管食管分路2例等方法重建发音功能者共25例。[结果]113例中有107例重建上消化道成功，并在短期内恢复经口进食功能，占总数的94．6％。失败6例，其中包括手术死亡2例（1．8％）。另有25例恢复或重建了发音功能。全组1、3、5年生存率分别为79．6％、60。2％、40．7％。[结果]所述上消化道重建方法是可靠而有效的，可根据患者具体情况选择恰当方法。所应用的发育功能重建方法也是可行的。
[Objective] To investigate the effectiveness, reliability and remaining problems of the reconstruction of upper digestive tract and pronunciation function during surgical treatment of hypopharynx and cervical esophageal cancer. [Methods] From April 1984 to December 1996, a total of 113 patients with hypopharyngeal and cervical esophageal tumors were treated surgically. Of these, 53 were treated with island-shaped pectoralis major myocutaneous flaps, 29 with pharyngeal anastomosis, 18 with residual pharyngeal mucosa, 5 with colonic esophagus, 4 with free jejunum, 3 with forearm free flap, and 1 with neck The flaps reconstruct the upper digestive tract. Twenty-five cases were reconstructed using the method of reserving 12 cases of total laryngectomy, 11 cases of partial laryngeal preservation, and 2 cases of tracheo-esophageal shunt. [Results] Of the 113 cases, 107 cases were successful in reconstructing the upper digestive tract and recovered oral function in the short term, accounting for 94.6% of the total. Failure occurred in 6 cases, including 2 deaths (1.8%). Another 25 cases restored or reconstructed the pronunciation function. The overall 1-, 3-, and 5-year survival rates were 79.6%, 60. 2%, and 40.7%, respectively. [Results] The method of reconstruction of the upper digestive tract was reliable and effective, and an appropriate method could be selected according to the specific conditions of the patient. The applied developmental function reconstruction method is also feasible.