摘要
目的：探讨T3期声门上喉癌喉功能保留手术的可行性、技术操作和临床疗效。方法：回顾性分析1994～2003年收治的T3期声门上癌70例，均行喉功能保留手术，其中喉声门上水平部分切除术42例，喉声门上水平垂直部分切除术19例，喉环状软骨上部分切除术8例，喉近全切除术1例。以胸骨舌骨肌肌筋膜瓣、颈阔肌肌皮瓣、双蒂接力肌甲状软骨膜瓣、甲状软骨膜瓣等修复喉腔组织缺损，重建喉功能。全部患者均接受术后放疗（剂量50～60Gy）。结果：3年生存率为79．2％，5年生存率为68．4％。70例患者中已拔管60例，拔管率为85．7％。全部患者均恢复经口进食，无明显呛咳及吞咽困难。所有患者均发声成功，无一例因喉腔闭锁而致发声失败。结论：T3期声门上癌虽属晚期喉癌，但只要严格掌握适应证，熟练运用多种修复方法，提高外科手术技巧，保留喉功能是可行的。
Objective：To explore the feasibility,surgical techniques and the clinical curative effect of preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma（SLC）. Method：A retrospective review of 70 cases with T3 SLC that we treated from 1994 to 2003 were accomplished. All of the cases were treated with partial laryngectomy. Among them,42 cases underwent supraglottic horizontal partial laryngectomy , 19supraglottic horizontovertical laryngectomy, 8 supracricoid partial laryngectomy and 1near total laryngectomy. All patients were received postoperation radiotherapy with the dosage for 50~60 Gy. Result：The 3 year and 5 yearsurvival rates were 79.2 % and 68.4 %, respectively. Out of the 70 cases, 60 cases were decannulated with a de-cannulation rate of 85.7 %. The normal diet was resumed in all patients, no bucking and dysphagia obviously. All patients had their successful phonation, no one failure for laryngotracheal atresia. Conclusion：It is feasibility to preservate laryngeal function in surgical treatment of T3 SLC, if surgeons master indications correctly, use many kinds restorative procedure expertly and improve surgical skill.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2006年第21期977-979,共3页
Journal of Clinical Otorhinolaryngology
关键词
喉肿瘤
喉切除术
喉功能
Laryngeal neoplasms, Laryngectomy
Laryngeal function
