摘要
目的：对T1～2期声门型喉癌喉小部分切除术不行预防性气管切开进行临床探讨。方法：45例T1～2期喉鳞状细胞癌患者采用不行气管切开的喉小部分切除术进行治疗。结果：45例患者切口全部I期愈合，平均术后住院时间11．5d；全部患者术后呼吸功能正常，无一例发生喉梗阻。术后29例患者发生轻度颈部皮下气肿，其中3例颈部皮瓣反复漂浮于创面之外，使皮瓣延迟至术后2周才与创面完全黏附愈合，其余26例均在术后4～6d完全吸收。颈部轻度皮下气肿对患者呼吸与吞咽功能、颈部切口愈合及患者的心理均未造成明显的干扰和影响。随访1～13年，其中2例因肿瘤复发或转移死亡，余均健在。全部患者吞咽、呼吸功能正常，目前尚未发现气管表面种植性转移者。结论：T1～2期声门型喉癌喉小部分切除术不行气管切开有解剖学和生理学上的理论基础，在临床上开展这一术式是可行的，术后康复过程安全。该术式是运用微创外科理念改造和优化喉癌外科手术的临床实证，它显著减轻了T1～2期声门型喉癌围手术期对患者解剖、生理及心理的创伤。
To investigate the teaslomty and clinical of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma. Method ： Forty-five patients with laryngeal squamaous cell car- cinoma in T1-2 stage received small partial laryngectomy without tracheotomy. Result： All patients were primarily healed and were hospitalized for an average of 11. 5 days post-operatively. In all patients, the function of respira- tion and the reflection of cough were normal, and laryngeal obstruction did not happen. The only postoperative complication was subcutaneous emphysema noted in 29 patients. Among them , subcutaneous emphysema extincted after 4-6 days in 26 patiens,only 3 patiens suffered from delayed healing because the subcutaneous emphysema extincted after 2 weeks. Mild subcutaneous emphysema did not affect the function of respiration and deglutition, healing of wound, and psychology of patients. All patients had been followed-up for 1-13 years. Only 2 patients died of tumor recurrence or metastasis. The function of respiration and deglutition were normal in the living pa- tients, and no implanting metastasis on surface of trachea were found. Conclusion： The theoretical foundation of small partial laryngectomy without tracheotomy for T1-2 stage glottic carcinoma has been well established. This sur- gical technique is feasible, safe and effective. It can significantly improve clinical outcome of T1-2 stage glottic carci- noma with minimal invasiveness. Furthermore, it can obviously abate the surgical, physiological and psychological trauma on patients.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2014年第16期1272-1274,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
喉肿瘤
喉切除术
气管切开术
laryngeal neoplasms
laryngectomy
tracheotomy
